The US Department of Justice has charged 21 people in multiple states with fraudulent claims related to COVID-19 medical assistance and sales of fake vaccination cards in the past two weeks.

Since the pandemic started, the US federal government has injected billions of dollars into the healthcare system. Some people tried to defraud the government by making false claims totaling $150 million. About $20 million has been paid out for some of those claims.

In Miami, Florida, a 43-year-old nurse was charged in connection with submitting more than $134 million of false and fraudulent claims to Medicare.

She and her co-conspirators allegedly signed several doctors' orders for medically unnecessary genetic testing and durable medical equipment in exchange for kickbacks in the form of sham telehealth consultation fees. The stated telemedicine consultations never happened.

In California, two 63-year-olds were charged with trying to defraud Medicare of more than $214 million for laboratory tests, of which $144 million was in false and fraudulent claims for COVID-19 and respiratory pathogen tests that were submitted without regard to medical necessity.

The indictment also alleges that they paid kickbacks to marketers who obtained specimens and test orders and laundered the proceeds of the scheme through shell companies. They allegedly used the money to buy real estate, luxury items and personal goods and services.

In Maryland, a medical director was charged with instructing his employees to submit claims to Medicare and other insurers for moderate or complex office visits even though those visits lasted only five minutes or less for a COVID-19 test. The fraudulent claims amounted to $1.5 million.

A New York state doctor was charged in connection with billing Medicare and Medicaid more than $1.3 million in claims for coronavirus testing that his office didn't provide.

A few others, including a post office worker, were charged with making and selling fake COVID-19 vaccination record cards.

Last year, the Department of Justice charged a dozen people in relation to similar types of fraud conducted by healthcare providers; false claims for $143 million were submitted to the government.

In May last year, the US attorney general established the COVID-19 Fraud Enforcement Task Force to combat pandemic-related fraud.

"These healthcare fraud abuses erode the integrity and trust patients have with those in the healthcare industry, particularly during a vulnerable and worrisome time for many individuals," Luis Quesada, assistant director of the FBI's Criminal Investigative Division, said in a Justice Department statement. "The actions of these criminals are unacceptable."