Filipino doctor in US convicted over $24-M health care fraud

NEW YORK —Dr. Alexander Baldonado, a Filipino-Canadian and U.S. permanent resident, was convicted on 10 counts of health care fraud totaling $24 million.

A US Department of Justice statement said court documents and evidence presented at trial showed that Baldonado received tens of thousands of dollars in illegal cash kickbacks and bribes in exchange for ordering laboratory tests, including expensive cancer genetic tests, which were billed to Medicare by two related laboratories in New York.

As part of the scheme, Baldonado was said to have authorized hundreds of cancer genetic tests for Medicare beneficiaries who attended COVID-19 testing events at assisted living facilities, adult day care centers, and a retirement community in 2020.

The 69-year-old doctor was not treating any of the patients at these events, and in many cases, he did not speak to or examine them prior to ordering the cancer genetic tests and other laboratory tests. He also billed Medicare for lengthy office visits that he never provided to these patients, the court documents also showed.

Several Medicare beneficiaries for whom Baldonado ordered cancer genetic tests and billed for office visits testified during the trial that they did not know who Baldonado was and had never met or spoken to him. Baldonado did not contact the patients after the testing events to review the results of the cancer genetic tests, and in some cases, the patients never received the test results.

In addition to the laboratory testing scheme, the US Justice Dept. said Baldonado received illegal cash kickbacks and bribes from the owner of a durable medical equipment supply company in exchange for ordering medically unnecessary orthotic braces for Medicare and Medicaid beneficiaries.

Evidence presented at trial showed Baldonado receiving a large sum of cash on an undercover video in exchange for signed prescriptions for orthotic braces.

The medically unnecessary laboratory tests and orthotic braces ordered by Baldonado in exchange for illegal kickbacks and bribes led to Medicare being billed more than $24 million. Medicare paid more than $2.1 million to the laboratories and the durable medical equipment supply company involved in the schemes, the statement said.

Baldonado was found guilty of one count of conspiracy to commit health care fraud, six counts of health care fraud, one count of conspiracy to defraud the United States and to pay, offer, receive, and solicit health care kickbacks, one count of conspiracy to defraud the United States and to receive and solicit health care kickbacks, and one count of solicitation of health care kickbacks.

Following his conviction on the 10 counts, Baldonado was remanded into the custody of the U.S. Marshals Service.

He is scheduled to be sentenced on June 26 and faces a maximum penalty of 10 years in prison for each count of conspiracy to commit health care fraud, health care fraud, and solicitation of health care kickbacks, and five years in prison for each count of conspiracy to defraud the United States and to pay, offer, receive, and solicit health care kickbacks, and conspiracy to defraud the United States and to receive and solicit health care kickbacks.

A federal district court judge will determine the sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

GMA Integrated News is trying to get a statement from Baldonado’s lawyer, Atty. Jose Muniz, but has yet to receive a response.—LDF, GMA Integrated News