Express Diagnostics and BioConfirm: The Marketers Supplied the Samples and the Orders

In the Express Diagnostics and BioConfirm genetic testing fraud case, the Justice Department reported approximately $522 million in false claims, of which Medicare, Medicaid and private insurers paid approximately $84 million. Its May 4, 2026 announcement described the criminal case against two laboratory operators who had pleaded guilty.

Marketers supplied DNA samples, insurance information and orders from medical providers who had neither treated nor consulted with the people being tested. The same referral business supplied the sample and the paperwork that made it look like a medical decision. Public health programs and private insurers paid for unnecessary testing whose results the ordering providers did not use in treatment.

What Is the Genetic Testing Scandal?

The Justice Department said the operation paid marketers to recruit people covered by Medicare, Medicaid and private insurance for medically unnecessary genetic testing. It described four laboratories under one operator’s control: Express Diagnostics in New Jersey, BioConfirm in Georgia, and Tox Management and Tri-State Toxicology in Texas. The announcement grouped BioConfirm Laboratory USA and BioConfirm Laboratories under the BioConfirm name.

A second operator shared control of Express Diagnostics and BioConfirm and paid marketers to obtain DNA samples and fraudulent test requisitions.

The announcement reported that the operator controlling the wider network had pleaded guilty to conspiring to commit health care fraud and wire fraud. The second operator had pleaded guilty to paying health care kickbacks. The department also reported guilty pleas by eleven others in the scheme, including marketers, doctors and nurse practitioners.

How Health-Fair Marketing Became a Laboratory Order

The Justice Department said that from 2018 through August 2020, the operators and others in the scheme paid kickbacks and bribes to marketers who obtained health insurance information and DNA samples. Its announcement identifies telemarketing, door-to-door solicitation, health fairs and other in-person solicitation as recruitment methods. The tests were designed to predict the risk of cancer, adverse drug reactions and other conditions.

The marketer’s job extended beyond finding someone willing to provide a sample. At the operators’ direction, and in exchange for payments, marketers also obtained fraudulent requisition forms from medical providers. Those providers had not treated or consulted with the beneficiaries and did not use the results in treatment.

That is the feature a laboratory sales or intake employee would recognize: the referral source was delivering both the person to be tested and the apparent clinical authority to test them. The health-fair encounter produced something the business could send to a laboratory. The requisition supplied the medical explanation for sending it.

The HHS Office of Inspector General’s genetic-testing alert describes the same recruitment settings in its broader warning about unnecessary tests and orders disconnected from a beneficiary’s treating physician. In this case, the Justice Department traced that pattern to named laboratories, the operators who paid the marketers and the documents used to support billing.

A Medical Record Written to Fit the Test

The Justice Department said the operator controlling the wider network falsified laboratory requisitions, letters of medical necessity and other medical records to make the tests appear legitimate. These were the documents meant to explain why a particular person needed testing. The department described them as part of the fraud itself.

The order looked like a medical decision, but the provider had neither treated nor consulted with the patient.

The industry has long recognized how much an order form can conceal. In June 1997, Laboratory Medicine‘s Model Plan Helps Laboratories Fight Fraud described federal recommendations for requisitions with space to document the medical necessity of each test. It also described notices explaining which individual tests made up a laboratory profile and how the laboratory would bill for them. The point was to make the testing and its billing visible to the ordering physician.

That makes the falsified requisitions at Express Diagnostics and BioConfirm especially revealing. The form was supposed to carry the clinical reason into the laboratory. The department says the operation manufactured that reason. A sample, an order and a completed set of medical forms could all arrive together without the treatment decision those forms appeared to document.

When Marketing Contracts Hide Referral Payments

The Justice Department said the operators disguised kickbacks and bribes as payments for marketing services. They created sham contracts, invoices and other documentation to conceal payments for obtaining DNA samples and fraudulent requisitions.

Do Doctors Get Kickbacks for Ordering Tests?

The Department of Justice reported that doctors and nurse practitioners pleaded guilty in this genetic-testing fraud and kickback scheme. Its announcement described marketers obtaining fraudulent requisitions from medical providers who had neither treated nor consulted with the people tested.

A separate whistleblower complaint involving UTC Laboratories, doing business as Renaissance Rx, and Blue Ox Medical Innovations alleged that doctors received cash for each tested patient without performing work for the testing.

What an Insider Knows About the Referral Chain

A requisition, a letter of medical necessity and a marketing invoice are the documents at the center of this case. Each supplied an explanation the Justice Department said was false: why the test was needed, who had ordered it and why the marketer was being paid.

An intake employee may know whether the clinical paperwork came from the ordering provider or arrived through the marketer with the sample. A person handling marketing payments may know whether the invoice described the work the recipient actually performed. A physician-office employee may know whether the provider named on an order ever saw or consulted with the patient. Those are different views of the decisions described in this criminal case.

We work with insiders to connect what they saw to the particular testing business. A person who knows how the requisitions were produced can explain something a claim alone will not show. A person who knows what the marketer was paid to deliver can explain why those requisitions kept arriving.

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Saw How the Orders Arrived

If your work connected recruited patients, genetic-test orders or marketer payments, speak to one of our whistleblower experts about how those orders arrived. We build the case with you and bring in healthcare fraud whistleblower lawyers who understand laboratory referrals and fabricated medical necessity. We stay beside you as the details you know become the foundation of the case.