Health Care Fraud: Seth Rehfuss Pleaded Guilty In One Count Of Conspiracy To Commit Health Care Fraud
Somerset County Man Sentenced to 50 Months in Prison for Role in Medicare Fraud
Defendant Used Purported Non-Profit to Convince Seniors to Submit to Genetic Testing; Paid Health Care Providers to Falsely Claim Tests Were Necessary
TRENTON, N.J. – A Somerset County, New Jersey, man was sentenced today to 50 months in prison for using the purported non-profit The Good Samaritans of America to defraud the Medicare Program of more than $430,000 by convincing hundreds of senior citizens to submit to genetic testing, U.S. Attorney Craig Carpenito announced.
Seth Rehfuss, 44, of Somerset, New Jersey, previously pleaded guilty before U.S. District Judge Ann E. Thompson to a superseding information charging him with one count of conspiracy to commit health care fraud. Judge Thompson imposed the sentence today in Trenton federal court.
According to documents filed in this case and statements made in court:
Rehfuss admitted that he used The Good Samaritans of America to gain access to groups of senior citizens in various low-income senior citizen housing complexes and persuaded them to submit to genetic tests without any involvement of a health care professional. Contrary to what he told the senior citizens and staff at the housing complexes, Rehfuss was a sales representative for laboratories, a fact he concealed from his targets. In order to convince senior citizens to submit to genetic testing, Rehfuss used fear-based tactics during the presentations, including suggesting the senior citizens would be vulnerable to heart attacks, stroke, cancer and suicide if they did not have the genetic testing.
To get the tests authorized, Rehfuss used advertisements on Craigslist to recruit health care providers for the scheme. The health care providers were paid thousands of dollars per month by Rehfuss and others to sign their names to requisition forms authorizing testing for patients they never examined or had any interaction with. Rehfuss and his conspirators, Sheila Kahl and Kenneth Johnson, established email accounts, phone numbers, and made-up “office manager” names for the requisition forms that made it seem as though the health care providers were actually treating the patients being swabbed and would be evaluating the test results.
Rehfuss, Kahl, Johnson, and others caused the Medicare program to pay two clinical laboratories for the fraudulent test claims that the scheme generated. They obtained and divided more than $100,000 in commission payments from the laboratories.
Rehfuss and others were also actively working towards expanding the scheme outside of New Jersey into other states, including: Georgia, Delaware, Virginia, Maryland, Pennsylvania, South Carolina, Michigan, Mississippi, Florida, Tennessee and Arizona.
In addition to the prison term, Judge Thompson sentenced Rehfuss to three years of supervised release, ordered him to pay restitution of $434,963 and forfeiture of $66,844.
Sheila Kahl, 47, of Ocean County, previously pleaded guilty and is scheduled to be sentenced May 13, 2019. Kenneth Johnson, 39, of Lorton, Virginia, pleaded guilty and is scheduled to be sentenced May 20, 2019.
U.S. Attorney Carpenito credited special agents of the U.S. Department of Health and Human Services – Office of the Inspector General, under the direction of Special Agent in Charge Scott J. Lampert; special agents of the U.S. Attorney’s Office for the District of New Jersey; and the Cape May County Department of Aging and Disability Services, with the investigation leading to today’s sentencing.
The government is represented by Assistant U.S. Attorneys Bernard J. Cooney, Sara F. Merin, and Danielle Alfonzo Walsman of the Health Care & Government Fraud Unit in Newark.