In response to one of the country’s largest health care fraud schemes, the Department of Justice (DOJ) indicted 35 individuals for improperly billing Medicare for unnecessary genetic tests. Individuals involved in the scheme include nine doctors, several telemedicine company recruiters, and lab technicians. Recruiters allegedly targeted elderly and disabled individuals with scare tactics, claiming that individuals were at increased risk for deadly harms without the tests.
The recruiters were claimed to have asked Medicare enrollees to provide their Medicare card and their identification card to receive a genetic test at no cost. The recruiter would try to get a referral from a doctor that saw the patient, but if that failed, a doctor affiliated with the scheme would order the test, even without seeing the patient. While the patient was not billed, Medicare was billed often between $10,000 and $18,000 per patient. In all, the defendants allegedly wrongfully billed Medicare for over $2 billion. The patient often purportedly did not receive their test results or received the results with no consultation or explanation of their meaning, ultimately rendering the results confusing and uninformative.
If convicted, the defendants could serve decades in prison.