DOJ: Maryland Man Facing Federal Indictment for Role in COVID-19 Healthcare Fraud Scheme Totaling More Than $100M

• Potash and co-conspirators used fraudulent documents to obtain a CLIA certification for Tiero, LLC and submitted false claims to insurers.
• The scheme resulted in over $50 million in insurance payments to Tiero for at-home, self-administered COVID-19 tests.

A Maryland man, Marc Aaron Potash, was indicted by a federal grand jury for conspiracy to commit healthcare fraud and seven counts of healthcare fraud, as well as five counts of conducting transactions in criminally derived proceeds. The charges relate to submitting false claims to Medicare, Medicaid, FEHBP, and other insurers for at-home COVID-19 tests.

Potash and his co-conspirators used fraudulent documents to obtain a CLIA certification for Tiero, LLC, then submitted claims with false dates, places, and providers. The scheme led to more than $100 million in false claims and over $50 million in insurance payments to Tiero.

• $100 million false and fraudulent healthcare claims submitted
• $50 million insurance payments to Tiero
• $4 million real property purchased in Beallsville, Maryland

• Review claims submitted by Tiero, LLC for at-home COVID-19 tests for false dates, places, and providers.
• Verify CLIA certifications and supporting documents for Maryland-based labs, especially those obtained via emails, letters, and paperwork to MDH.
• Screen insurance payments exceeding $50 million to single entities for potential fraud linked to self-administered COVID-19 tests.

This case highlights the vulnerability of healthcare benefit programs to large-scale fraud schemes exploiting pandemic-related testing. Compliance officers must scrutinize claims for at-home COVID-19 tests, verify laboratory certifications, and monitor unusually high insurance payments to single entities. The indictment demonstrates the importance of cross-agency collaboration and the need for robust controls to detect and prevent fraudulent claims, especially those involving false documentation and misrepresentation of services. Enhanced vigilance is required to protect insurers and federal programs from similar schemes.