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Missouri Man Charged with $174 Million Health Care Fraud in Louisiana
A Missouri man and a New Orleans resident have been charged with conspiring to commit health care fraud and wire fraud in a scheme that defrauded Medicare of $174 million.
Jamie P. McNamara, 48, of Missouri, and John M. Spivey, 53, of New Orleans, were charged by a grand jury on May 10, 2024, in an 18-count superseding indictment.
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.
The 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 is 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.
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.
U.S. Attorney Duane A. Evans reiterated that the superseding indictment is merely a charge and that the guilt of the defendant must be proven beyond a reasonable doubt.
Defendant/Respondent: Jamie P. McNamara
Criminal Charges: 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
City and State: New Orleans, Louisiana
Exact Date: May 10, 2024
Sentence or Outcome: Pending
Dollar Amounts: $174 million (loss) and $55 million (reimbursement)
Key Facts
- State: Louisiana
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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