Missouri Man Gets 10 Years for $174M Medicare Genetic Testing Fraud Scheme

On Oct. 23, a Missouri man was sentenced to 10 years in prison for orchestrating a scheme to defraud Medicare by unlawfully billing hundreds of millions of dollars in claims for cancer genetic testing and cardiovascular genetic testing.

According to court documents, Jamie P. McNamara, 50, of Kansas City, operated several laboratories in Louisiana and Texas, which obtained doctors’ orders for genetic testing from telemarketers and call centers that used aggressive telemarketing campaigns to induce Medicare beneficiaries to agree to receive genetic testing. Orders for genetic testing were signed by purported telemedicine doctors who were not the beneficiaries’ treating physicians, did not perform consultations with the beneficiaries and did not follow up with the beneficiaries after the testing was performed. To obtain the orders, McNamara paid illegal kickbacks and bribes, which he disguised through sham contracts. In furtherance of the scheme, he also shifted the billing between his laboratories to evade scrutiny from Medicare and law enforcement and concealed his ownership and control of the laboratories by falsely listing the names of his family members as owners and company representatives on Medicare and other documents. In approximately one and a half years, the laboratories operated by McNamara submitted over $174 million in claims to Medicare for genetic testing and received over $55 million in reimbursements. The government previously seized several luxury vehicles from McNamara and over $7 million in bank accounts.

While on pretrial release, McNamara violated his bond conditions by, among other things, fleeing from an unrelated arrest and cutting off an ankle monitor. He was subsequently detained. McNamara pleaded guilty to conspiracy to commit health care fraud.

Acting Assistant Attorney General Matthew R. Galeotti of the Justice Department’s Criminal Division; Acting U.S. Attorney Michael M. Simpson for the Eastern District of Louisiana; Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services, Office of Inspector General (HHS-OIG); and Acting Special Agent in Charge Jonathan Tapp of the FBI New Orleans Field Office made the announcement.

HHS-OIG and FBI investigated the case.

Assistant Chief Justin M. Woodard and Trial Attorney Kelly Z. Walters of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Nicholas Moses for the Eastern District of Louisiana prosecuted the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force program. Since March 2007, this program, currently comprised of 9 strike forces operating in 27 federal districts, has charged more than 5,800 defendants who collectively have billed federal health care programs and private insurers more than $30 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. 

Editor’s Note: Do you enjoy Townhall’s conservative reporting that takes on the radical left and woke media? Support our work so that we can continue to bring you the truth.

Join Townhall VIP and use the promo code FIGHT to get 60% off your VIP membership!

On Oct. 23, a Missouri man was sentenced to 10 years in prison for orchestrating a scheme to defraud Medicare by unlawfully billing hundreds of millions of dollars in claims for cancer genetic testing and cardiovascular genetic testing.

According to court documents, Jamie P. McNamara, 50, of Kansas City, operated several laboratories in Louisiana and Texas, which obtained doctors’ orders for genetic testing from telemarketers and call centers that used aggressive telemarketing campaigns to induce Medicare beneficiaries to agree to receive genetic testing. Orders for genetic testing were signed by purported telemedicine doctors who were not the beneficiaries’ treating physicians, did not perform consultations with the beneficiaries and did not follow up with the beneficiaries after the testing was performed. To obtain the orders, McNamara paid illegal kickbacks and bribes, which he disguised through sham contracts. In furtherance of the scheme, he also shifted the billing between his laboratories to evade scrutiny from Medicare and law enforcement and concealed his ownership and control of the laboratories by falsely listing the names of his family members as owners and company representatives on Medicare and other documents. In approximately one and a half years, the laboratories operated by McNamara submitted over $174 million in claims to Medicare for genetic testing and received over $55 million in reimbursements. The government previously seized several luxury vehicles from McNamara and over $7 million in bank accounts.

While on pretrial release, McNamara violated his bond conditions by, among other things, fleeing from an unrelated arrest and cutting off an ankle monitor. He was subsequently detained. McNamara pleaded guilty to conspiracy to commit health care fraud.

Acting Assistant Attorney General Matthew R. Galeotti of the Justice Department’s Criminal Division; Acting U.S. Attorney Michael M. Simpson for the Eastern District of Louisiana; Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services, Office of Inspector General (HHS-OIG); and Acting Special Agent in Charge Jonathan Tapp of the FBI New Orleans Field Office made the announcement.

HHS-OIG and FBI investigated the case.

Assistant Chief Justin M. Woodard and Trial Attorney Kelly Z. Walters of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Nicholas Moses for the Eastern District of Louisiana prosecuted the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force program. Since March 2007, this program, currently comprised of 9 strike forces operating in 27 federal districts, has charged more than 5,800 defendants who collectively have billed federal health care programs and private insurers more than $30 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. 

Editor’s Note: Do you enjoy Townhall’s conservative reporting that takes on the radical left and woke media? Support our work so that we can continue to bring you the truth.

Join Townhall VIP and use the promo code FIGHT to get 60% off your VIP membership!