A New York physician has been sentenced to seven years in prison for his role in a scheme that resulted in more than $24 million in fraudulent Medicare claims. Alexander Baldonado, M.D., 69, of Queens, was also ordered to pay over $2.2 million in restitution.
Court documents and trial evidence revealed that Baldonado received illegal cash kickbacks and bribes for ordering laboratory tests, including costly cancer genetic tests, which were billed to Medicare by two laboratories based in New York. The scheme involved authorizing hundreds of cancer genetic tests for Medicare beneficiaries who attended COVID-19 testing events at various assisted living facilities, adult day care centers, and a retirement community during 2020.
Baldonado did not treat or examine the patients before ordering these tests and billed Medicare for office visits he never conducted. Several patients testified at trial that they had never met or spoken with Baldonado and were unaware of who he was. In many cases, patients did not receive the results of the cancer genetic tests ordered on their behalf.
Additionally, Baldonado accepted illegal payments from the owner of a durable medical equipment supply company in exchange for prescribing unnecessary orthotic braces to Medicare and Medicaid beneficiaries. Evidence included undercover video footage showing Baldonado receiving cash for signed prescriptions.
The fraudulent activity led to more than $24 million being billed to Medicare, with over $2.2 million paid out based on false claims.
Following a five-day jury trial in February 2025, Baldonado was convicted on multiple counts: one count of conspiracy to commit health care fraud; six counts of health care fraud; one count each of conspiracy to defraud the United States related to health care kickbacks; and solicitation of health care kickbacks.
"Acting Assistant Attorney General Matthew R. Galeotti of the Justice Department’s Criminal Division; Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services, Office of Inspector General (HHS-OIG); and Special Agent in Charge James E. Dennehy of the FBI Newark Field Office made the announcement."
The investigation was conducted by HHS-OIG and the FBI. Acting Principal Assistant Chief Rebecca Yuan from the Criminal Division’s Fraud Section prosecuted the case.
The Justice Department’s Fraud Section leads efforts against health care fraud through its Health Care Fraud Strike Force Program. Since its inception in March 2007, this program has charged over 5,800 defendants accused collectively of billing federal health programs and private insurers more than $30 billion (https://www.justice.gov/criminal-fraud/health-care-fraud-unit). The Centers for Medicare & Medicaid Services are also working with HHS-OIG to hold providers accountable for involvement in such schemes.
