A New Orleans man has been ordered to pay more than $7 million in restitution for his role in a genetic testing fraud scheme that billed Medicare more than $174 million, according to an Oct. 21 news release from the U.S. Attorney’s Office for the Eastern District of Louisiana.
On Oct. 13, a federal judge ordered John Spivey, 55, to pay $7 million to Medicare, jointly and severally with co-defendant Jamie McNamara, 50, of Missouri. Mr. Spivey, who pleaded guilty to conspiracy to commit healthcare fraud, had previously been sentenced to five years of probation, the first year in home confinement.
Mr. McNamara, with Mr. Spivey’s help, operated several laboratories that billed Medicare for cancer and cardiovascular genetic tests that weren’t medically necessary and were obtained through kickbacks. Telemarketers and call centers persuaded beneficiaries to take the tests, and the orders were signed by purported telemedicine physicians who weren’t the beneficiaries’ treating physicians and didn’t consult with or follow up with them. From November 2018 through July 2020, the labs submitted more than $174 million in false claims and received more than $55 million.
Mr. McNamara, who also pleaded guilty, was sentenced to 10 years in prison and ordered to pay $174 million in restitution. He was also ordered to forfeit about $7 million and three vehicles seized before his indictment.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
