February 25, 2025 | JacobiJournal.com – A New York doctor, Alexander Baldonado, M.D., has been convicted of orchestrating a $24 million Medicare fraud scheme. A federal jury found him guilty of submitting fraudulent claims for medically unnecessary lab tests and orthotic braces.
How the Scheme Worked
Medicare Fraud Scheme: According to court documents and trial evidence, Baldonado received illegal cash kickbacks for ordering unnecessary cancer genetic tests and orthotic braces. These fraudulent claims were billed to Medicare by two New York-based laboratories.
In 2020, Baldonado authorized hundreds of cancer genetic tests for Medicare patients at COVID-19 testing events in assisted living facilities, adult day care centers, and a retirement community. However, he never treated or examined these patients before ordering tests. Many testified that they had never met or spoken to him.
Additionally, Baldonado billed Medicare for office visits he never conducted. He never followed up with patients about their test results, and some never received them.
Bribes for Orthotic Braces
Baldonado also accepted illegal kickbacks from a medical equipment supplier in exchange for prescribing unnecessary orthotic braces. Undercover video evidence showed him receiving a large sum of cash for signing prescriptions.
Financial Impact
The fraudulent claims totaled more than $24 million. Medicare paid over $2.1 million to the laboratories and the medical equipment company involved in the scheme.
Conviction and Sentencing
A jury found Baldonado guilty of:
- Conspiracy to commit health care fraud (1 count)
- Health care fraud (6 counts)
- Soliciting and accepting illegal kickbacks (3 counts)
Following his conviction, authorities took him into custody. He faces up to 10 years in prison per fraud-related charge and up to 5 years per kickback charge. His sentencing is scheduled for June 26.
Investigation and Prosecution
The FBI Newark Field Office and HHS Office of Inspector General led the investigation. Assistant Chief Rebecca Yuan and Trial Attorney Hyungjoo Han from the Justice Department’s Fraud Section prosecuted the case.
For more updates on Medicare fraud, visit DOJ.gov.
FAQs: Medicare Fraud Scheme
What was the Medicare fraud scheme involving Dr. Alexander Baldonado?
Dr. Baldonado was convicted of running a Medicare fraud scheme by billing for unnecessary cancer genetic tests and orthotic braces, many for patients he never treated.
How much money was involved in the Medicare fraud scheme?
The fraudulent claims totaled over $24 million, with Medicare paying more than $2.1 million to laboratories and equipment suppliers tied to the scheme.
What penalties does a Medicare fraud scheme conviction carry?
Convictions for a Medicare fraud scheme can result in up to 10 years in prison per fraud charge and up to 5 years per illegal kickback charge.
Who investigated the Medicare fraud scheme in New York?
The FBI Newark Field Office and the HHS Office of Inspector General led the investigation, working with the Justice Department’s Fraud Section.
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