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Missouri And New Orleans Men Charged with $174 Million Conspiracy to Commit Healthcare Fraud

U.S. Attorney Duane A. Evans announced that JAMIE P. McNAMARA (“McNAMARA”), age 48, of Missouri, and JOHN M. SPIVEY (“SPIVEY”), age 53, of New Orleans, were charged by a grand jury on May 10, 2024 in an 18-count superseding indictment for conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to pay and receive kickbacks, offering and paying kickbacks, conspiracy to commit money laundering, and money laundering. McNAMARA was previously charged in the original indictment, returned on July 14, 2022, and the May 10, 2024 superseding indictment added SPIVEY.

According to the superseding indictment, McNAMARA and SPIVEY orchestrated a scheme to defraud Medicare by billing for cancer genetic testing and cardiovascular genetic testing that was ineligible for Medicare reimbursement because the testing was not medically necessary and was procured through the payment of illegal kickbacks and bribes. McNAMARA and SPIVEY operated several laboratories, which obtained doctors’ orders for genetic testing from telemarketers and call centers that used aggressive telemarketing campaigns to induce Medicare beneficiaries to agree to receive genetic testing. Orders for genetic testing were signed by purported telemedicine doctors who were not the beneficiaries’ treating physicians, did not perform consultations with the beneficiaries, and did not follow up with the beneficiaries after the testing was performed. The superseding indictment alleges that from in or around November 2018 through July 2020, the laboratories operated by McNAMARA and SPIVEY submitted over $174 million in false and fraudulent claims to Medicare for genetic testing and received over $55 million in reimbursements. Following receipt of proceeds, McNAMARA and SPIVEY conspired to and did launder the funds. The government seized several luxury vehicles and over $7 million in bank accounts.

McNAMARA is charged in every count of the superseding indictment, and SPIVEY in charged in the Count 1 conspiracy to commit health care fraud and wire fraud. If convicted of the conspiracy to commit health care fraud and wire fraud, McNAMARA and SPIVEY face up to twenty years in prison. For each of the eight the health care fraud counts, McNAMARA faces up to ten years in prison. For the conspiracy to pay and receive kickbacks, McNAMARA faces up to five years in prison, and for both of the counts of offering and paying kickbacks, McNAMARA faces up to ten years in prison. For the conspiracy to commit money laundering and the two concealment money laundering counts, McNAMARA faces up to twenty years in prison, and for the transactional money laundering counts, McNAMARA faces up to ten years in prison. Both defendants face up to three years of supervised release following any term of imprisonment, as well as a fine of up to $250,000 or twice the gross gain to any defendant or loss to any person. The defendants also face a $100 mandatory special assessment per count.

U.S. Attorney Evans reiterated that the superseding indictment is merely a charge and that the guilt of the defendant must be proven beyond a reasonable doubt.

The case was investigated by the U.S. Department of Health and Human Services – Office of Inspector General and the Federal Bureau of Investigation. The case is being prosecuted by Assistant U.S. Attorney Nicholas D. Moses and Department of Justice Trial Attorneys Kelly Z. Walters and Justin M. Woodard.