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Billion Dollar Healthcare Fraud Scheme Unraveled By The Feds; 36 People Charged

Multiple people have been charged in a massive healthcare fraud scheme totaling $1.2 billion.

On Wednesday, the Justice Department announced charges against 36 participants in the nationwide scheme. The elaborate system was conducted by lab owners and company executives who ordered unnecessary tests and equipment and then billed Medicare and other insurance companies for them. The accused allegedly ordered these items sometimes without any interaction with patients. When they did speak with patients, it was via telemedicine appointments.

Additionally, medical laboratory owners and operators are being accused of paying illegal kickbacks to medical professionals, medical equipment companies, and even telemedicine companies in exchange for patient referrals.

In one case, Jamie McNamara of Missouri, owner of New Orleans-based Clarity Diagnostic Laboratories, Opteo Laboratory, and Signify Laboratory, used his “shell laboratories” to conduct the operation. Allegedly, he devised a plan to have marketing companies pay telemedicine centers to call patients and offer them no-cost, Medicare-approved cardiovascular and genetic testing. Doctors were compensated to clear the testing even if the patients didn’t need them. His labs submitted claims to Medicare worth more than $174 million. McNamara then laundered the money through multiple bank accounts to fund his lavish lifestyle.

Christopher Thigpen of Hammond, Louisiana, owns Akrivis Laboratories. He ran a similar scheme, bringing in $65 million with the help of McNamara. Millions of dollars in kickbacks to telemarketers or other testing labs was paid in exchange for referrals and patient information.

Many of the accused have been charged with fraud, conspiracy, money laundering, and disbursing illegal kickbacks. The case is also the first of its kind, specifically targeting cardiovascular genetic testing fraud.

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