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The Justice Department has accused two owners of a medical lab in Southern California of running a $144 million Medicare fraud scheme that billed thousands of patients for unnecessary medical diagnostics — after luring them in with coronavirus tests.

The indictment was part of a raft of charges the Justice Department and the Department of Health and Human Services announced on Wednesday against 21 people across the country. Those people, officials said, were involved in schemes that totaled about $149 million in false Medicare billing related to the sweeping federal response to the pandemic.

“While millions of Americans were suffering and desperately seeking testing and treatment for Covid-19, some saw an opportunity for profit,” Kenneth A. Polite Jr., assistant attorney general for the criminal division, said during a news conference at the Justice Department.

The schemes included printing phony vaccination cards and selling fake test results, as well as more complicated scams that enticed older or ailing patients to accept unneeded treatments, tests and telehealth visits in California, Florida, Maryland, New Jersey, New York, Tennessee, Utah and Washington.

But the biggest case by far was the one filed this week against two lab owners, Imran Shams and Lourdes Navarro, both 63, of Glendale, Calif., who have been charged in an elaborate plan that involved paying kickbacks to telemarketers who upsold patients seeking virus testing on unnecessary blood work and urinalysis.

The indictment accuses the pair of laundering their profits through shell companies controlled by Ms. Navarro and using the cash to buy “real estate, luxury items, and personal goods and services.”

In 2000, Mr. Shams and Ms. Navarro were convicted of trying to defraud Medi-Cal, California’s Medicaid program, by filing false claims using patient information bought illegally. Mr. Shams has been barred from filing for Medicare reimbursement ever since, and prosecutors say he concealed his involvement in operating the lab involved in the current case.

That lab, Health Care Providers Lab, did not immediately respond to a request for comment.

Several other cases followed a similar pattern, including a federal indictment against a cardiologist on Long Island accused of billing Medicare and Medicaid for $1.3 million in unneeded tests on patients who visited a mobile coronavirus testing site he operated.

Federal prosecutors in Miami have also charged a registered nurse for taking advantage of loosened Covid-19 telehealth rules. She billed the federal government for about $1 million in unnecessary or undelivered medical services, they said.

Several of the cases announced on Wednesday involved the falsification of vaccination cards or test results, or the peddling of phony virus treatments.

In Utah, a former employee with a company that provided preflight coronavirus tests at Salt Lake City International Airport was charged with selling negative test results to passengers who were about to board flights to Israel and Hawaii, which had stringent Covid-19 protocols.

Lisa Miller, a deputy assistant attorney general who works on fraud cases, said most of the people charged with selling fake cards wanted to make easy money.

But in at least one case, profit motive seemed to be mingled with ideology.

In New Jersey, prosecutors charged a Postal Service employee with making and distributing 400 fake vaccination cards, in part to “undermine” the federal government’s role in ensuring that people comply with public health requirements, according to prosecutors.

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