Lab operator sentenced to prison for $174M Medicare fraud scheme

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A Kansas City, Mo.-based man was sentenced to 10 years in prison for orchestrating a Medicare fraud scheme involving false claims for cancer genetic testing and cardiovascular genetic testing. 

What happened? 

1. Jamie McNamara, 50, operated several labs in Louisiana and Texas, according to a Nov. 19 Justice Department news release. The labs obtained physicians’ orders for genetic testing from telemarketers and call centers that used aggressive telemarketing campaigns to induce Medicare beneficiaries to agree to receive testing. The orders were signed by telemedicine physicians who never treated or consulted with the patients. 

2. To obtain the orders, Mr. McNamara paid kickbacks and bribes that he disguised through sham contracts, according to the release. He also shifted billing across labs to avoid detection and hid his ownership by listing family members as company representatives. 

3. He submitted more than $174 million in fraudulent claims to Medicare over the course of 18 months and received more than $55 million in reimbursements, according to the release. 

4. In addition to the prison sentence, Mr. McNamara was ordered to pay more than $55 million in restitution and to forfeit more than $7 million that was previously seized by the government. 

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