Two men were sentenced over a genetic testing scheme that prosecutors say generated more than $522 million in fraudulent Medicare/Medicaid/insured claims. DOJ alleged DNA tests were obtained via illegal kickbacks and bribes and that lab and medical records were falsified to make the testing appear legitimate.

According to the U.S. Department of Justice, two men received prison sentences for their roles in a large-scale genetic testing fraud and illegal kickback operation tied to federally funded and insured health-care programs. Prosecutors alleged that “marketers” targeted Medicare, Medicaid, and privately insured individuals to obtain DNA samples, using improper payments to steer patients into unnecessary testing. The alleged scheme then relied on falsified laboratory and medical documentation to support billing for medically unnecessary genetic tests. DOJ described the case as involving both fraudulent claims submission and an illegal kickback structure designed to monetize patient eligibility and identity in the health-care billing system. The government’s theory included that records were manipulated to create the appearance of clinical justification, enabling the tests to be billed as legitimate services. The result was an alleged $522 million in fraudulent claims. The sentencing underscores continued enforcement against health-care solicitation and kickback-based models that profit from distorted patient intake and fabricated medical paperwork.