New Orleans Man Ordered to Pay Over $7 Million in Restitution for Medicare Genetic Testing Fraud Conspiracy
The U.S. Attorney's Office for the Eastern District of Louisiana announced that John M. Spivey, 55, of New Orleans, was ordered on October 13 to pay over $7 million in restitution for his role in a conspiracy to commit health care fraud. U.S. Attorney David I. Courcelle made the announcement.
According to court documents, Spivey conspired with co-defendant Jamie P. McNamara, 50, of Missouri, to defraud Medicare by billing for cancer genetic testing and cardiovascular genetic testing that was ineligible for reimbursement because it was not medically necessary and was procured through illegal kickbacks and bribes. McNamara, assisted by Spivey, operated several laboratories that obtained doctors' orders from telemarketers and call centers using aggressive campaigns to induce Medicare beneficiaries to agree to testing; the orders were signed by purported telemedicine doctors who were not the beneficiaries' treating physicians and performed no consultations or follow-up. From November 2018 through July 2020, the laboratories submitted over $174 million in false and fraudulent claims to Medicare and received over $55 million in reimbursements. Both men pleaded guilty.
U.S. District Judge Darrel J. Papillion ordered Spivey to pay $7,002,410.26 in restitution to Medicare, jointly and severally with McNamara, and sentenced Spivey to five years of probation, the first year in home confinement. McNamara was previously sentenced to 10 years in prison and $174 million in restitution, and was ordered to forfeit approximately $7 million and three vehicles. The case was investigated by the U.S. Department of Health and Human Services Office of Inspector General and the FBI.
Published by GSM · USA (original Chinese edition)
Photo: 图：位于 New Orleans 的 Hale Boggs 联邦大楼与美国法院大楼。照片：Ktkvtsh 摄，CC BY 4.0，经 Wikimedia Commons。 / The Hale Boggs Federal Building and United States Courthouse in New Orleans. Photo by Ktkvtsh, CC BY 4.0, via Wikimedia Commons.
