Riverside Genetic Testing Marketer: Per-Test Kickbacks Routed Through New Zealand

In the Riverside genetic testing fraud case, a marketer’s companies received $1,700 to $2,000 for each cancer genetic test Medicare reimbursed, according to the Justice Department’s account of his guilty plea. The payments passed through a New Zealand company, with invoices claiming hourly referral work. The business paid for results: a test that brought in Medicare money returned a kickback to the marketer.

The marketing-company owner, from Riverside, California, pleaded guilty on January 8, 2025 to conspiracy to violate the federal Anti-Kickback Statute. The Justice Department’s plea account places the scheme between November 2018 and January 2020 and attributes more than $10 million in Medicare losses to it.

What the Marketer Was Paid to Deliver

The guilty-plea announcement describes a business built around identifying Medicare beneficiaries for at-home cancer genetic tests. The marketer owned and controlled California marketing companies. He and the other participants passed beneficiaries’ personal and medical information to testing companies, which arranged to send out testing kits. When the tests came back completed, participants submitted claims to Medicare.

The marketer’s companies earned their kickback when a test resulted in reimbursement. A name on a lead list was the beginning of the transaction. The Medicare payment was what made it pay.

The indictment described Medicare reimbursement of approximately $7,700 for each qualifying test during the period it covered. The laboratory could bill for the testing, while the marketing business received a fee for supplying the patient whose test generated the payment.

That division of work is central to this case. The marketer controlled the patient leads. The testing companies arranged the testing, healthcare providers supplied prescriptions, and a Florida laboratory performed tests and submitted claims. The indictment described those separate roles in a single chain that ended with money returning to the source of the leads. It also described the laboratory’s Medicare enrollment promise to follow the Anti-Kickback Statute, with payment depending on compliance by both the claim and the transaction behind it.

From a Cold Call to a Medicare Claim

The indictment alleged that the marketers made unsolicited calls to elderly Medicare beneficiaries across the country and entered qualifying patients’ information into an online portal operated by the testing companies. Those companies then arranged for telemedicine providers to contact the beneficiaries. The marketers also had their own relationships with providers who supplied prescriptions.

The problem was what those prescriptions represented. The indictment alleged:

The filing alleged that participants sent kits whether beneficiaries needed or wanted them. Beneficiaries completed the kits and returned them to the laboratory, which performed the tests and submitted claims electronically. The government’s charging announcement described the same patient-acquisition process, including unsolicited calls to elderly cancer patients.

The allegation concerned how the business obtained the order and why it sought the patient in the first place. The prescription supplied the paperwork for a test that the marketing operation had already set in motion.

The Specimens Came Before the Requisitions

The indictment alleged that participants sometimes collected hundreds of cancer genetic testing specimens without a corresponding doctor’s prescription or requisition. Concerned that the missing orders would alert Medicare to the lack of legitimate medical need, they waited to send the specimens to the laboratory until they knew they could obtain requisition forms.

The patient material had already been collected. The business then needed a doctor to supply the paperwork that would let it move forward. Someone handling specimens or requisitions would see a different part of that transaction from someone handling the eventual claim.

The indictment described the treating physician’s role as ordering a test for a patient’s specific medical problem and using the result to manage that problem. The ordering practitioner keeps the reason for the test in the patient’s chart. The lab keeps the information it receives and records showing that its claim matches that information.

In its June 1997 article Model Plan Helps Laboratories Fight Fraud, Laboratory Medicine described the inspector general’s recommendation for requisition forms with space for a physician to document the medical necessity of each test using a diagnosis code. It also described recommendations to retain records and analyze test-use data.

That gives the missing requisitions their significance here. The form was meant to carry a clinical reason for testing. The indictment described a business collecting patient specimens first and holding them while it arranged to obtain the forms. The order’s place in the sequence is part of the evidence, alongside what the form eventually said.

The New Zealand Company and the Hourly Invoices

The Justice Department’s guilty-plea account says the testing companies sent kickback payments to a New Zealand company, which sent the money onward to U.S. bank accounts controlled by the marketer. It describes a sham contract that made one of his marketing companies appear to be providing legitimate marketing and referral services to the New Zealand business.

The invoices gave those payments a different explanation. They purported to charge for hourly referral services. The actual compensation depended solely on how many cancer genetic tests Medicare reimbursed. Hours appeared on the bill. Paid tests determined the money.

The indictment adds detail about how participants controlled the route. It alleged that people in New Jersey directed payments from the New Zealand shell company through WhatsApp and text messages. The contract described payment for hours and expenses, while the underlying arrangement paid for qualified patient leads.

One alleged transaction makes the route concrete. After participants supplied approximately 55 leads late in 2018, the testing-company owner wired payment to the New Zealand company on February 4, 2019. The following day, that company sent $110,000 to the marketer’s U.S. company as payment for those leads, according to the indictment.

The filing also described a later route in which the testing companies paid another of the marketer’s companies directly. The recipient and route changed while payments remained tied to patient leads. The foreign bank transfer, the invoice and the patient list each show a different part of the same alleged transaction.

Why Genetic Testing Drew the Money

A paid cancer genetic test could support a substantial referral payment, as the reimbursement and kickback amounts in this case show. The wider Medicare spending pattern helps explain the commercial attraction of genetic testing.

In its report on laboratory spending in 2024, the Department of Health and Human Services inspector general found that genetic tests, including human and pathogen tests, represented 5% of Medicare Part B laboratory tests but accounted for 43% of laboratory spending, or $3.6 billion.

Another Laboratory Payment With a Different Label

In the 2018 Primex Clinical Laboratories and DNA Stat settlement, the government alleged that payments to physicians appeared to buy clinical data for a Primex-sponsored study but actually paid for patient referrals. The stated purpose was research. The alleged purchase was access to patients.

The Riverside plea account describes a different disguise, hourly marketing and referral services, around a similar transaction. In both accounts, the explanation attached to the payment concealed what generated it. That is the connection worth following across the cases: the service named in the contract and the activity that actually earned the money.

The Records Behind a Genetic Testing Whistleblower Case

Patient leads, requisitions, claims, invoices and bank transfers connect the clinical and commercial sides of this case.

A laboratory employee may know when the specimen arrived and when the order followed. A marketing employee may know what made a lead payable. A person handling accounts may know why an invoice changed when reimbursed tests changed. Those are different views of the same business arrangement, and our whistleblower experts work with insiders to connect them.

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

You Know What Made the Referral Pay

If you saw testing orders assembled around purchased leads or hourly invoices tied to paid claims, speak to one of our Whistleblower Experts about how the referrals were paid. We bring in laboratory fraud whistleblower lawyers who understand referral payments and Medicare billing to build your strongest genetic testing whistleblower case. We stay beside you from the first account of the payment arrangement through the pursuit of a recovery.