A Kansas City, Mo.-based man has pleaded guilty to a Medicare fraud scheme involving false claims for cancer genetic testing and cardiovascular genetic testing, the Justice Department said in a May 29 news release.
What happened?
- James McNamara ran several labs in Louisiana and Texas that fraudulently billed Medicare for genetic testing. The labs used aggressive telemarketing to obtain testing orders from beneficiaries, which were signed by telemedicine physicians who never treated or consulted with the patients.
- Mr. McNamara paid kickbacks disguised as legitimate contracts, shifted billing across labs to avoid detection and hid his ownership by listing family members as company representatives.
- In 18 months, the labs submitted over $174 million in claims and received $55 million in payments.
What’s next?
- Mr. McNamara is set to be sentenced on Sept. 9 and faces up to 10 years in prison.
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