Advanced Tele-Genetic Counseling: Selling Genetic-Test Signatures

Advanced Tele-Genetic Counseling’s owner entered a guilty plea for her role in a health care kickback conspiracy involving payments for signed cancer genetic-test orders. Her company received money from marketers and paid doctors for orders. For someone inside a laboratory, marketing company or telemedicine business, the question is what the signature bought: medical care or paperwork for a claim.

The Justice Department’s December 21, 2021 account of the owner’s guilty plea describes Advanced Tele-Genetic Counseling’s role from approximately February 2018 through August 2019. The company supplied the signed orders between patient recruitment and laboratory billing.

How the Genetic-Test Order Chain Worked

Marketers recruited Medicare and Medicaid patients, Advanced Tele-Genetic Counseling supplied doctors’ orders, and Crestar Labs performed tests and billed the programs. The government’s account of the owner’s criminal plea places Genetix among the marketing companies paying for those orders.

The recruitment happened door to door, at senior citizen fairs, in nursing homes and at other locations. Marketers persuaded patients to provide genetic material through mouth swab kits. They delivered the kits to Crestar Labs in exchange for kickbacks from the laboratory.

The test was cancer genomic testing. As the Justice Department explained, it uses DNA sequencing to detect mutations that could indicate a higher risk of developing certain cancers in the future. It does not diagnose whether someone currently has cancer.

Advanced Tele-Genetic Counseling’s part was supplying the medical order. Marketers paid the company for signed orders, and its owner paid doctors to sign them without regard to medical necessity. The laboratory then billed Medicare and Medicaid for the tests.

The marketer brought the sample, the telemedicine company arranged the signature, and the laboratory submitted the claim. Looking only at the laboratory bill would leave the purchase of the doctor’s order out of the story.

What the Owner Knew About the Orders

According to the Justice Department’s account of her criminal plea, the owner knew the signing doctors were not the patients’ treating physicians. She knew they were not treating a specific medical problem, symptom, illness or diagnosis, and were not using the results in patient care. She also knew the doctors often never contacted the patients at all. The plea account describes doctors paid to supply signed orders while the clinical relationship and the use of the result were missing.

For an insider who recognizes a doctor signing a genetic-test order without seeing the patient, the payment arrangement is part of the same story. In this case, the government’s account ties the owner’s knowledge of the missing care directly to the business of purchasing signatures. The transaction reached the laboratory and the payer, but the medical purpose of the order had fallen away.

The Money Paid for the Signatures

Advanced Tele-Genetic Counseling received approximately $234,730 in illegal kickback payments from marketing-company participants, including Genetix, according to the plea announcement. That was the intermediary’s receipt for its part in the order chain. Medicare and Medicaid, meanwhile, paid laboratories, including Crestar, millions in reimbursements the government said they were not entitled to receive because the tests were procured through kickbacks and were otherwise ineligible for payment.

The separate criminal complaint against Crestar’s owner, described by the Justice Department on July 6, 2021, alleged the laboratory side of the business. It said Crestar billed Medicare approximately $86 million from late 2017 through that announcement and was paid almost $14 million for those claims. Those figures describe Crestar’s broader billing, separately from the payments received by Advanced Tele-Genetic Counseling.

The complaint also alleged that patients or their treating physicians often never received the results. That adds another break in the care: even the doctor already treating the patient could be left without the information.

The money connected the businesses. The clinical information failed to make the same journey.

What a Later Physician Trial Showed

A later criminal trial showed the volume of orders a paid physician could supply. In its September 5, 2023 account of the physician’s conviction, the Justice Department said trial evidence showed that he ordered thousands of cancer genetic tests without meeting the patients in person or through telemedicine, and without reviewing their results.

The physician and others caused more than $9.5 million in fraudulent Medicare and Medicaid claims from March 2019 through September 2019. Telemedicine companies paid him for signed orders. Marketing companies paid those companies and delivered swabs to a laboratory in Spring Hill, Tennessee, which paid the marketers and billed the programs. The criminal trial account shows how a physician’s repeated approvals could feed claims far beyond the business issuing the orders.

When a Portal Turns Approval Into Medical Paperwork

In a separate Delaware civil case, a physician’s admitted statement of facts described how her approvals through MySpecialistMD generated signed orders and medical-necessity documents without an existing treating relationship. That case shows how an approval can supply the paperwork behind a laboratory claim.

What Evidence Is Needed to Report Fraud?

For a business selling genetic-test signatures, the useful evidence connects the patient contact, signed order, payment and laboratory claim. We work with insiders to understand what those records say together: what the doctor was asked to do, what the signature represented, and what caused money to change hands.

The underlying transaction may be spread across companies. A marketing employee may know how beneficiaries were recruited and what the company purchased from an order intermediary. A clinician or telemedicine employee may know what information was available before approval. Laboratory staff may see the order, sample, claim and result distribution. Those different views can explain the same test from recruitment through reimbursement.

You Know What the Signature Bought

If you know who paid for genetic-test orders or how approvals became laboratory claims, talk with our whistleblower experts about the business behind those signatures. We build the case with you, bring in healthcare fraud whistleblower lawyers who understand laboratory billing and paid referrals, and stay beside you through the pursuit of a recovery. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.