Powder Springs Chiropractor Genetic Testing Fraud: Per-Lead Invoices Behind a Sham Agreement

A Powder Springs chiropractor used per-lead laboratory invoices and a sham agreement to disguise kickbacks in an equipment and genetic testing fraud scheme that cost Medicare more than $14.9 million, according to the Justice Department’s account of her guilty plea. The chiropractor operated durable medical equipment businesses and a cancer genetic testing company. For someone handling laboratory payments, the revealing detail is what the invoices charged for: a beneficiary lead.

The Georgia chiropractor pleaded guilty in Newark federal court on June 20, 2024, to conspiring to commit healthcare fraud and to violate the federal Anti-Kickback Statute. The Medicare loss covered the combined equipment and genetic-testing scheme.

Orthotic Braces, Call Centers and Telemedicine Orders

In its account of her guilty plea, the Justice Department described a durable medical equipment business that obtained doctors’ orders for orthotic braces without regard to medical necessity. The chiropractor and her co-conspirators owned, operated or had financial interests in the durable medical equipment companies. Marketing call centers and telemedicine companies supplied the orders, including through companies based in Florida.

According to the plea announcement, the participants caused false claims to reach Medicare and paid illegal kickbacks. The order gave the equipment claim its medical appearance, even though the business obtained it without regard to whether the beneficiary needed the brace. Taxpayers paid the false claims. The patient’s need went disregarded.

The cancer genetic testing company supplied a clinical laboratory with leads of beneficiaries qualified to receive federal health care benefits for those tests. The distinctive laboratory document was an invoice seeking payment per lead.

What the Laboratory Invoice Was Hiding

According to the Justice Department’s account of her guilty plea, the chiropractor submitted per-lead invoices to the clinical laboratory while entering a sham agreement to disguise kickbacks and bribes. The invoice identified the unit being sold. The agreement concealed the nature of the payment.

In its account of guilty pleas involving the operators of Express Diagnostics and BioConfirm, the Justice Department described sham contracts and invoices that disguised kickbacks as payments for marketing services.

The Laboratory Bills, but the Practitioner Holds the Medical Story

A laboratory’s claim depends on a medical decision made upstream. Under Medicare’s diagnostic-test rules, the treating practitioner orders the test and retains the documentation establishing medical necessity. The laboratory performs the service, reports the result and submits the claim. Its work begins with a decision and information supplied by somebody else.

That separation matters when a marketer supplies a stream of beneficiaries. A lead establishes a commercial connection to a patient. The clinical order must establish why that patient needs the test. In the Powder Springs case, the invoice tells us what the referral supplier wanted the laboratory to pay for.

The laboratory profession has described this problem for decades. The 1997 Laboratory Medicine article Model Plan Helps Laboratories Fight Fraud discussed the inspector general’s recommendation that laboratories use requisition forms with space for a diagnosis code documenting the medical necessity of each test. It also described written explanations to ordering physicians of test profiles, their individual components and how the laboratory would bill Medicare.

A sales process that produces a referral still has to answer the medical question. For a laboratory employee, the order and its supporting information explain a different part of the transaction from the marketer’s invoice.

What Evidence Is Needed to Prove Fraud?

The per-lead invoice, the agreement, the medical order and the laboratory claim, read together, can connect the referral payment to the test billed to Medicare. In the Powder Springs criminal case, the per-lead invoices and sham agreement exposed the payment arrangement.

A call-center worker may understand how beneficiaries were recruited. A laboratory employee may know what arrived with the order and what was billed. Someone handling payments may know why the invoice rose with the referral count. We work with that operational knowledge to build the case around the conduct you actually saw.

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

You Know What the Invoice Bought

If you saw beneficiary leads priced, test orders generated or referral payments dressed up as services, speak with our whistleblower experts about how the leads were bought. We build your strongest genetic-testing fraud case with you, bring in whistleblower lawyers who know laboratory billing and telemedicine referrals, and stay beside you throughout the case.