New Orleans Man Ordered to Pay $7 Million in Medicare Genetic Testing Scheme Fed by Telemarketing Call Centers

The bottom line: telemarketing was the front end of this Medicare fraud, and the people behind it are now paying for it.

Here is what happened

According to the U.S. Attorney's Office release, Spivey conspired with his codefendant, Jamie P. McNamara, 50, of Missouri, to defraud Medicare. The government says that they billed Medicare for cancer genetic testing and cardiovascular genetic testing that was not eligible for reimbursement.

The release gives two reasons the testing was ineligible:

• It was not medically necessary.
• It was procured through the payment of illegal kickbacks and bribes.

McNamara, with Spivey's assistance, operated several laboratories. Those laboratories obtained doctors' orders for genetic testing from telemarketers and call centers. According to the release, those call centers "used aggressive telemarketing campaigns to induce Medicare beneficiaries to agree to receive genetic testing."

The orders were then signed by purported telemedicine doctors. The release states that these doctors were not the beneficiaries' treating physicians, did not perform the consultations with the beneficiaries, and did not follow up with them after testing.

The numbers

According to court records cited in the release, from November 2018 through July 2020, the laboratories operated by McNamara submitted more than $174 million in false and fraudulent claims to Medicare for genetic testing. Medicare paid more than $55 million on those claims.

Both McNamara and Spivey pleaded guilty.

The sentences

On October 13, 2026, United States District Judge Darrel J. Papillion ordered that Spivey pay $7,002,410.26 in restitution to Medicare, jointly and severally with McNamara. "Jointly and severally" means each defendant can be held responsible for the full amount until it is paid.

The release also reports the earlier outcomes in the case:

1. McNamara was sentenced to 10 years in prison and ordered to pay $174 million in restitution. He was also ordered to forfeit approximately $7 million in funds and three vehicles that were seized before he was indicted.
2. Spivey was sentenced to five years of probation, with the first year served in home confinement.

The U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation (FBI) investigated the case. Attorneys from the Department of Justice (DOJ) Fraud Division and the U.S. Attorney's Office prosecuted it.

Why it matters

This was a criminal health care fraud case, not a Telephone Consumer Protection Act (TCPA) case. But the pattern is a familiar one for anyone who works in outbound calling.

The telemarketing campaign was not a side detail. According to the government, it was how the laboratories generated the orders they billed. Call centers persuaded Medicare beneficiaries to agree to the testing. Telemedicine doctors who never treated those beneficiaries signed the orders. The laboratories then billed Medicare.

TCPA.com has covered several other prosecutions built on the same chain: call center, telemedicine signature, lab or supplier billing. Each link depends on the others. A call center that sells "leads" or "orders" into that chain can end up as evidence in someone else's fraud case, or be a defendant in its own.

Practical takeaways

1. Know what you are selling. If your calls generate orders for a medical test or product, understand who signs the order and who bills for it.
2. Avoid per-order pay in health care. Payments tied to each order or referral for items billed to federal health programs could raise kickback concerns. Obtain advice before you agree to that structure.
3. Check the doctor relationship. A legitimate order comes from a provider who actually treats or consults with the patient.
4. Script honestly. The release specifically calls out "aggressive telemarketing campaigns" aimed at Medicare beneficiaries. That is the language you never want describing your floor.
5. Vet your buyers. Ask where your calls or leads go and how they are used. Walk away if the answers are vague.

Telemarketing that feeds Medicare billing gets examined from both ends. Build your program so it holds up when it is.

Source: U.S. Attorney's Office for the Eastern District of Louisiana, New Orleans Man Sentenced To $7 Million In Restitution For Health Care Fraud Conspiracy.