As we all become more familiar with the benefits of COVID-19 testing, a recent Department of Justice case demonstrates how some types of medical testing could be abused.
In 2018 and 2019, marketers convinced seniors in nursing homes, at fairs and at their own homes to provide their genetic material for unnecessary Cancer genomic tests, the Justice Department revealed Tuesday.
These tests – which use DNA sequencing to detect mutations in genes that could indicate a higher risk of developing certain types of cancers – weren’t used by doctors to care for the seniors. In fact, doctors who signed orders for the tests often never even contacted patients about the results.
According to the Justice Department, the tests were really just part of an illegal kickback conspiracy.
Elizabeth Turner a 34-year-old resident of Glenview, Ky., pleaded guilty yesterday in U.S. District Court in Nashville to conspiracy to pay and receive health care kickbacks, acting U.S. Attorney Mark H. Wildasin for the Middle District of Tennessee announced.
She was the owner of Advanced Tele-Genetic Counseling (ATGC), a telemedicine company from February 2018 to August 2019.
Turner was charged for conspiring with Fadel Alshalabi, the owner of Tennesee-based Crestar Labs, LLC, and Melissa Lynn “Lisa” Chastain, the owner of the South Carolina-based marketing company Genetix, LLC, said the Justice Department. Other marketers and physicians were also charged in relation to the scheme to offer, pay, solicit and receive illegal kickbacks and to defraud the Medicare and Medicaid Programs.
While Turner owned ATGC, the company paid kickbacks to doctors who signed orders of Cancer genomic tests, “without regard for the medical necessity of the tests,” said the Justice Department. Cancer genomic tests cannot determine whether a patient presently has cancer.
“Turner knew the doctors were not the patients’ treating physicians, were not treating the patients for any specific medical problem, symptom, illness, or diagnosis, and were not using the results in the care of the patients,” said the department.
Medicare and Medicaid patients would provide marketers with genetic samples via a mouth swab kit. Marketers would then send the samples to Crestar Labs in exchange for kickbacks and Crestar would in turn bill Medicare and Medicaid.
Overall, ATGC received approximately $234,730 in illegal kickback payments from marketing company co-conspirators, including Genetix. Medicare and Medicaid paid laboratories such as Crestar Labs millions of dollars in reimbursements they were not entitled to receive.
Now Turner faces up to five years in prison and could be fined up to $250,000 in restitution to Medicare and Medicaid. She is expected to be sentenced May 2.
The U.S. Department of Health and Human Services, Office of the Inspector General, and the Federal Bureau of Investigation investigated the case. Assistant U.S. Attorneys Sarah K. Bogni and Robert S. Levine are prosecuting.
Defendants are presumed innocent until proven guilty in a court of law, said the Justice Department.
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