Premier Medical and Freedom Medical: Paid Orders, Missing Results

The Premier Medical and Freedom Medical telemedicine case ended in $114.5 million in civil judgments and settlements over kickbacks for cancer genetic testing. The government’s account describes marketers offering people cash for DNA samples, buying remote physician orders and feeding the tests into Medicaid billing. Most of the people who supplied samples never received their results. Inside the business, someone had to connect the collection kit, the Medicaid card and the purchased order.

Premier Medical was a clinical laboratory in Greenville, South Carolina. By the time the government announced the resolutions, the laboratory had closed and Georgia, Colorado and South Carolina had terminated it from Medicaid. Freedom Medical Labs supplied referrals. In its July 17, 2025 announcement, the Justice Department described different outcomes for the laboratory, its former owner, its former compliance executive, Freedom Medical and two marketers.

A former Premier employee brought the qui tam case under the False Claims Act. The United States and the states of Georgia, Colorado and South Carolina joined it. What followed reached the people arranging the samples and orders as well as the lab that billed for the tests.

How the Medicaid Order Chain Worked

The governments alleged that Premier paid Freedom Medical and its marketers kickbacks for cancer genetic testing referrals. They targeted Medicaid beneficiaries in Georgia, Colorado and South Carolina because those states reimbursed favorably for the tests.

The Centers for Medicare & Medicaid Services’ telehealth toolkit explains that states choose the services, practitioners, technology and payment arrangements their Medicaid programs cover, within federal requirements. The Premier allegations show why the payer behind the patient mattered to the people recruiting samples.

The governments alleged that, in 2018 and 2019, the Freedom marketers set up tables at bus stops, dollar stores and street corners in low-income areas. They falsely advertised cancer screening and offered people up to $20 for DNA samples. They took samples only from people with Medicaid cards. For the lab, the same person meant a potential reimbursement close to $12,000 in Georgia or close to $9,500 in Colorado, according to the Justice Department.

The marketers then paid a telemedicine company for a provider’s order for each person’s genetic test. The governments alleged that Premier’s side knew the orders and samples had been obtained through kickbacks in violation of the Anti-Kickback Statute. A sample recruited in a public place acquired a physician’s order and became the basis for laboratory billing.

The Medicaid card was part of the selection process. The order came afterward. Recruitment supplied the person and the sample, while the telemedicine company supplied the provider’s order.

A Physician’s Order Without a Treating Relationship

The government said the providers ordering these tests had no treating relationship with the beneficiaries. Patients never spoke to a provider, and most never received test results. The governments described the claims as medically unnecessary because the tests did not come from valid orders by patients’ treating providers.

That puts the order itself at the center of the telemedicine arrangement. The lab had a document authorizing a test. The person whose DNA was tested had no conversation with the provider who authorized it. The supposed cancer screening could generate a bill without delivering a result to the person recruited for it.

The broader business model appears in the HHS Office of Inspector General’s July 2022 Special Fraud Alert. It describes companies recruiting patients and practitioners, paying for reviews or signatures, and passing the resulting orders to businesses downstream. The order can be the product the telemedicine operation sells.

That alert identifies inadequate patient contact, business limited to federal program beneficiaries and missing follow-up among the features of suspect arrangements. In Premier’s case, the government’s account follows those connections all the way to the laboratory and the Medicaid programs paying for testing.

The Compliance Executive Who Connected the Transactions

Premier’s former vice president of compliance admitted helping the companies target Medicaid beneficiaries by shipping collection kits to marketers, running eligibility checks and coordinating directly with a telemedicine group to obtain physician orders. Those tasks connect the public recruitment to the laboratory’s work. The executive said Premier’s former owner and chief executive directed him to do them.

For someone who handled these transactions, the connection between departments may be the most recognizable part of the case. Shipping, eligibility and order coordination can look like separate administrative jobs. His admission connects them to the companies’ effort to obtain tests from particular Medicaid beneficiaries.

Premier Medical and Freedom Medical Telemedicine Judgment Amounts

The laboratory and the people arranging its orders received different resolutions. The Justice Department’s account of the resolutions gives each participant’s terms:

The harm to Medicaid was a different set of figures. The government attributed losses of $7,071,860 to Georgia Medicaid, $6,581,567 to Colorado Medicaid and $118,803 to South Carolina Medicaid.

According to the same Justice Department announcement, the two marketers had previously pleaded guilty in a separate criminal case to similar conduct involving cancer genetic testing referrals to a Tennessee laboratory. Their referral business had reached another lab.

Kickbacks to Physician Practices for Blood and Urine Samples

The former employee’s earlier complaint in the same case described another referral arrangement at Premier, involving physician practices sending blood and urine samples for testing. The employee worked with billing and contacted practices to obtain missing information, including diagnosis codes.

In that complaint, the whistleblower alleged that stalled billing paperwork exposed why referrals were being sent:

The complaint alleged that Premier usually paid the agreed kickback, after which physicians continued sending samples and the lab billed for testing. This earlier account concerned payments to physician practices. The later cancer-testing account concerned public recruitment and purchased telemedicine orders. Both show why someone handling routine paperwork can see the relationship between a referral payment and a laboratory bill.

The Same Business in Samples and Orders

Genexe and Immerge agreed with two executives to a $6 million settlement in another genetic-testing referral case. The government alleged that contractors collected samples, the companies obtained physician orders through telemedicine companies or laboratory arrangements, and laboratories received the samples and orders in return for a share of Medicare receipts.

The contractors allegedly recruited at stores, fairs, churches and retirement centers. The same commercial pieces recur: a recruited beneficiary, a collected sample, an acquired physician order and a laboratory claim.

Genexe and Immerge‘s alleged arrangement involved Medicare. Premier’s case targeted particular state Medicaid programs. In each account, the marketer supplied the lab with both the specimen and the paperwork needed to turn it into a testing claim.

Why the Records Between Companies Matter

The connection between a kickback and a government claim is the subject of Plausible Cause: Connecting the FCA and AKS in the Context of Health Care Fraud, published in the Rutgers University Law Review in 2024. The paper’s analysis emphasizes that companies possess the records and understand the billing processes that can explain the connection.

The recruitment, eligibility check, order and claim sat at different points in the business. The compliance executive’s admissions connected several of those points. The former employee’s complaint described how missing billing information led back to an unpaid referral payment.

For an insider, knowing why a sample went to one lab, who arranged its order or why a bill could not proceed can reveal a relationship that the final claim does not explain. We work with that knowledge to connect the people making decisions to the transactions they caused.

Can You Get Paid for Reporting Medicaid Fraud?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. A former employee brought the case here, which the United States and three states joined.

You Know How the Orders Reached the Lab

If you handled collection kits, Medicaid eligibility checks or purchased physician orders, tell our whistleblower experts how the business worked. We build the case with you, bring in healthcare fraud whistleblower lawyers who understand laboratory referral payments and telemedicine orders, and stay beside you through the pursuit of a recovery.