West Palm Beach Telemarketer Doctor Chase Fraud: The Call Center Wrote the Medical Story

Doctor chase fraud involving a West Palm Beach telemarketer generated more than $67 million in false Medicare claims for genetic testing, according to the Department of Justice’s account of the criminal trial. Call-center employees gave patients’ own physicians false reasons to authorize the tests. The resulting orders supported the billing, while the test results went unused in the patients’ treatment. For someone inside a physician’s office or laboratory, the revealing question is who supplied the medical story behind the order.

The telemarketer managed a division devoted to obtaining those authorizations. The government’s trial account describes deceptive calls targeting thousands of Medicare beneficiaries and their physicians, medical paperwork created by the call center, and laboratories that sent all the testing elsewhere. The operation depended on getting a clinical approval for a test the sales operation had already set in motion.

How Doctor Chase Fraud Obtained Physician Orders

The doctor chase division contacted the primary care physicians of targeted Medicare beneficiaries and tricked them into ordering medically unnecessary genetic tests. In its account of the evidence presented at the criminal trial, the Department of Justice described the manager’s specific instruction to employees: tell providers that the beneficiaries were “mutual patients” who requested these genetic tests, and that they had medical conditions justifying genetic testing, “when neither statement was true.”

The beneficiary was the doctor’s own patient. The claimed request for genetic testing and the medical justification were false. The call center asked the physician to authorize testing on the strength of paperwork it had created.

This is why the existing relationship mattered to the operation: the call center went to the real physician and fed false information into a real ordering decision.

The Department of Justice’s later account of the trial evidence describes what happened next. The manager and his co-conspirators used the doctors’ orders to submit Medicare claims for expensive, medically unnecessary genetic tests.

Why the Genetic-Test Order Needed a Medical Reason

A genetic-test order connects a patient’s medical problem to the test intended to help manage it. Under Medicare’s diagnostic-test ordering rule, the treating physician orders the test and uses the result in managing the patient’s specific problem. The qualified practitioner making that decision also maintains the documentation of medical necessity.

The separation between clinical judgment and laboratory billing has long been part of the industry’s own discussion. The 1997 Laboratory Medicine article Model Plan Helps Laboratories Fight Fraud explains the Department of Health and Human Services’ Office of Inspector General’s recognition that laboratories cannot treat patients. It describes uniform requisition forms with room for the physician to document each test’s medical necessity through a diagnosis code, and notices explaining the tests included in laboratory profiles.

In the West Palm Beach telemarketer’s criminal case, the call center supplied the supposed medical reason and persuaded the physician to approve it. The form became the place where a sales pitch acquired medical authority. The question is where the account of the patient’s condition originated, and how it reached the claim.

The Laboratories on the Claims Had No Testing Operation

The Department of Justice’s criminal trial announcement described a complete separation between the laboratories used in the scheme and the laboratories doing the work:

The same announcement says the manager and his co-conspirators referred all the genetic tests to other laboratories. Those laboratories performed the tests for a small fraction of the price charged to Medicare. Taxpayers paid the shell operation’s price.

For an insider, the distinction identifies separate parts of the transaction: the company obtaining the order, the laboratory performing the test, and the operation submitting the claim. Someone handling laboratory referrals may see the destination of the testing. Someone handling billing may see the Medicare charge. Those views can explain how the operation worked together.

The results complete the picture. The government’s trial account says they often never reached the beneficiaries’ primary care physicians and were not used in treatment. The operation pursued the physician’s approval before billing, but the medical information produced by the test often did not get back to that physician. The ordering relationship mattered to getting paid. Its purpose in caring for the patient was lost.

The Jury’s Finding and Medicare’s Payments

A federal jury in Fort Pierce convicted the call-center manager on October 6, 2023, of conspiracy to commit wire fraud and conspiracy to commit money laundering.

In its December 6, 2024 announcement, the Department of Justice put Medicare’s payments at more than $53 million and dated the false claims from May 2020 through July 2021. Medicare paid for unnecessary testing that contributed nothing to the health care of the patients whose doctors were deceived.

Paid Telemedicine Orders Show a Related Pattern

The Department of Justice’s account of the criminal trial involving Scott Global, an Orlando telemarketing call center describes bribes and kickbacks paid to telemedicine companies for doctors’ authorizations, while the West Palm Beach doctor-chase division obtained orders by deceiving beneficiaries’ existing physicians. The doctor’s place in the chain tells an insider where the relevant knowledge may sit: with the telemedicine operation, the physician’s office, or the callers seeking approval.

What a Laboratory Insider May Know

The manager’s instructions matter because they connect the false information to a decision inside the business. The obtained orders then connect that decision to billed testing. Someone who worked on only one part of the operation can explain a link that the claim alone does not show.

If you worked with those calls, orders or claims, your knowledge can show how a medical reason appeared in paperwork and whose decision put it there. We work with insiders to connect that knowledge to the testing and the government payments, and to assess the strongest civil whistleblower case the facts support.

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

You Know Where the Medical Story Started

If the calls or paperwork you handled supplied false reasons for genetic testing, speak to one of our Whistleblower Experts about who wrote the medical story. We build the case with you, bring in healthcare whistleblower lawyers who understand genetic-testing orders and laboratory billing, and stay beside you throughout the case.