Missouri Man Pleads Guilty in $8.7 Million Genetic Testing Fraud Scheme   

by Rrita Osmani and Pearl Berzin

On May 29, 2025, Missouri man Jamie McNamara, pleaded guilty to his role in a conspiracy involving fraudulent Medicare claims for unnecessary genetic testing and durable medical equipment (DME), made possible using sham telemedicine consultations.

According to the DOJ, McNamara operated laboratories in Louisiana and Texas, which he utilized to enact the scheme.  The labs hired telemarketers to call Medicare beneficiaries and convince them to agree to genetic testing and medical equipment that had not been prescribed by their primary doctor.  After a patient had agreed to receive testing or equipment, a telemedicine physician who had never met or spoken to them would sign off on the order.  McNamara bribed physicians and telemedicine centers to sign fraudulent claims through sham contracts. Over time, McNamara’s laboratories received approximately $55 million in reimbursements for submitting over $174 million in fraudulent claims.

This case is just one example of a growing problem in healthcare fraud, particularly related to genetic testing and telemedicine. While telemedicine offers a legitimate way for healthcare providers to reach patients remotely, it has increasingly been exploited by fraudsters looking to take advantage of Medicare’s reimbursement policies.

Understanding Genetic Testing Fraud and Telemedicine Billing Abuse

Genetic testing fraud is committed when Medicare and other insurance companies are billed for genetic testing that was not medically necessary or not ordered by the physician treating the patient.  Oftentimes, this involves orders for testing that are not covered by Medicare or similar health plans.

Telemedicine became increasingly popular during the COVID-19 pandemic because it gave patients access to healthcare providers without the fear of disease spreading.  In the case of genetic testing fraud, however, telemedicine centers often play a dangerous role.  As a seemingly trustworthy source of medical advice, these centers can persuade patients to pursue unnecessary testing under the guise that it is medically necessary and Medicare-approved.

The Role of Whistleblowers in Uncovering Medicare Scams

Whistleblowers are key in uncovering and prosecuting healthcare fraud. In many cases, the fraud is difficult to detect and even harder to prove without the assistance of insiders who have firsthand knowledge of the company. These whistleblowers, often former employees or industry insiders, can provide invaluable evidence that law enforcement and investigators would otherwise struggle to obtain.

For example, in genetic testing fraud cases, whistleblowers may have access to incriminating materials such as scripts for telemarketing calls, billing records, and communications about kickbacks or improper business practices. The False Claims Act (FCA) provides legal protections for whistleblowers, allowing them to report fraud while maintaining their anonymity. Complaints filed under the FCA are sealed at first, which protects whistleblowers from retaliation, such as job loss or harassment.

Whistleblowers can also receive a financial reward if the government recovers funds through a lawsuit filed under the FCA, with rewards ranging from 15% to 30% of the total recovery. This financial incentive has made whistleblowing an important tool in combating Medicare fraud.

What Penalties Do Healthcare Fraudsters Face?

McNamara faces up to 10 years in prison and substantial fines with sentencing scheduled for September 9th. In past cases, courts have also ordered restitution, forfeiture of assets, and bans from participating in federal healthcare programs.

“Misleading patients with fraudulent genetic testing schemes to exploit the Medicare program is not just unethical — it’s criminal,” said Deputy Inspector General for Investigations Christian J. Schrank of HHS-OIG. “Today’s plea reflects HHS-OIG’s steadfast commitment to holding those who deceive patients and seek to cripple the integrity of our nation’s federal health care programs accountable. We will continue to collaborate with our law enforcement partners to investigate such schemes and bring those responsible to justice.”

What To Do If You Suspect Telemedicine Billing Fraud

Attorneys at Miller Shah are highly experienced in supporting whistleblower claims through the FCA. Lawyers can guide you through the process, ensuring deadlines are met, and enhancing your claim through strong legal theory. Securing legal counsel can help preserve your anonymity to protect against retaliatory attacks and will provide you with the necessary resources to counter retaliation. By partnering with whistleblower attorneys at Miller Shah LLP, you can help the government counter medical testing fraud and win recoveries.