The owner of Conclave Media Conclave and Nationwide Health Advocates Nationwide pleaded guilty in connection with a $44 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces, and genetic tests. David Santana, 38, of Reading, Mass. pleaded guilty to one count of conspiracy to commit healthcare fraud. Between January 2018 and August 2021, Santana, through his companies Conclave and Nationwide, entered into business relationships with telemarketing companies that generated leads by targeting Medicare beneficiaries. The telemarketers then paid Conclave and Nationwide on a per-order basis to generate orders for DME and genetic testing for these beneficiaries. To arrange for these orders to be signed, Santana worked with medical staffing companies to find doctors and nurses who were willing to review and sign prepopulated orders, typically without any contact with the beneficiaries. The records falsely portrayed the medical providers as having performed a legitimate examination of the beneficiary. Santana then provided the signed orders to the telemarketing companies which sold the orders to DME suppliers and laboratories. Santana knew these DME suppliers and laboratories would use the signed orders to submit claims to Medicare for DME and genetic testing that were medically unnecessary, based on false documentation and tainted by kickbacks.
