A federal jury has found a New York doctor guilty of orchestrating a fraudulent scheme that led to the submission of over $24 million in false claims to Medicare. Dr. Alexander Baldonado, 69, of Queens, was convicted for his role in ordering medically unnecessary laboratory tests and orthotic braces in exchange for illegal kickbacks and bribes.
According to court documents and evidence presented at trial, Dr. Baldonado received substantial cash payments for ordering unnecessary laboratory tests, including costly cancer genetic tests. These tests were billed to Medicare by two New York-based laboratories. Many of these tests were ordered for unsuspecting Medicare beneficiaries who attended COVID-19 testing events at assisted living facilities, adult day care centers, and retirement communities in 2020. Baldonado was not treating these patients, nor did he speak with or examine them before ordering the tests. Testimony from multiple Medicare patients revealed that they had never met or even heard of Dr. Baldonado. Many never received their test results, and the doctor did not follow up with any medical consultation.
In addition to the fraudulent lab testing, Baldonado was caught on undercover video receiving large sums of cash in exchange for signing prescriptions for orthotic braces. These braces, like the tests, were medically unnecessary but were used to generate fraudulent Medicare and Medicaid claims.
The services ordered by Baldonado resulted in Medicare being billed over $24 million. Of this amount, more than $2.1 million was paid out to the laboratories and durable medical equipment companies involved in the scheme.
Dr. Baldonado was convicted on one count of conspiracy to commit health care fraud, six counts of health care fraud, one count of conspiracy to defraud the U.S. and to pay, offer, receive, and solicit health care kickbacks, one count of conspiracy to defraud the U.S. and to receive and solicit health care kickbacks, and one count of solicitation of health care kickbacks.
Following his conviction, Baldonado was taken into custody by 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 health care fraud and solicitation of kickbacks, and up to five years in prison for each conspiracy charge. His ultimate sentence will be determined by a federal district court judge, who will consider the U.S. Sentencing Guidelines and other legal factors.