A 55-year-old New Orleans man, John M. Spivey, has been ordered to pay more than $7 million (£5.4 million) in restitution for his involvement in a massive Medicare healthcare fraud conspiracy.
Spivey conspired with Jamie P. McNamara, 50, of Missouri, to defraud the US public health insurance program by billing for ineligible cancer and cardiovascular genetic testing.
Court documents revealed the tests were ineligible for reimbursement because they were not medically necessary and were obtained through illegal kickbacks and bribes.
McNamara, assisted by Spivey, operated several laboratories that acquired doctors’ orders for genetic testing through aggressive call centre campaigns targeting Medicare beneficiaries.
The orders were signed by purported telemedicine doctors who were not the patients’ treating physicians, never held consultations with them, and failed to conduct post-testing follow-ups.
Between November 2018 and July 2020, the laboratories submitted over $174 million (£134 million) in fraudulent claims to Medicare, securing more than $55 million (£42 million) in payouts.
Both men pleaded guilty to their roles in the conspiracy.
US District Judge Darrel J. Papillion ordered Spivey to pay $7,002,410.26 in joint restitution alongside McNamara. Spivey was sentenced to five years of probation, with the first year to be served under home confinement.
McNamara was previously sentenced to 10 years in prison and ordered to pay $174 million in restitution. Authorities also seized three vehicles and approximately $7 million in funds from him prior to his indictment.
US Attorney David I. Courcelle commended the Federal Bureau of Investigation and the US Department of Health and Human Services Office of Inspector General for investigating the case.
The prosecution was led by the Justice Department’s Fraud Division alongside federal prosecutors from the Eastern District of Louisiana.
By: Rainbowradioonline.com/Ghana
