New Orleans Man Gets Probation in $174 Million Medicare Fraud

New Orleans Man Gets Probation in $174 Million Medicare Fraud

Prosecutors say labs billed Medicare $174 million for unneeded genetic tests. One man got probation. His codefendant got 10 years.

By Lynn Matthews

A New Orleans man will spend five years on probation, the first year in home confinement, and owes Medicare more than $7 million for his part in a lab scheme that billed the program for $174 million, according to the U.S. Attorney’s Office for the Eastern District of Louisiana. The scheme ran from November 2018 through July 2020.

John M. Spivey, 55, pleaded guilty for his role. U.S. District Judge Darrel J. Papillion ordered $7,002,410.26 in restitution, an amount Spivey shares with his codefendant. The restitution order is dated Oct. 13.

How the Scheme Worked

Prosecutors say Spivey helped Jamie P. McNamara, 50, of Missouri, who operated several laboratories. The labs billed Medicare for genetic tests for cancer and heart disease that were not medically necessary and were obtained through kickbacks and bribes, the office says.

Patients were found by telemarketers and call centers that pressed Medicare beneficiaries to accept the tests. Doctors who signed the orders were described as telemedicine physicians. They were not the patients’ treating doctors, did not consult with them and did not follow up after testing, according to the release. The labs submitted over $174 million in false claims and were paid over $55 million.

Two Defendants, Two Outcomes

McNamara received a far heavier sentence. He was ordered to serve 10 years in prison and to pay $174 million in restitution. He was also ordered to forfeit about $7 million in funds and three vehicles that were seized before he was indicted. The release does not mention prison time for Spivey and does not name the specific charge to which he pleaded guilty.

The HHS Office of Inspector General and the FBI investigated. U.S. Attorney David I. Courcelle announced the sentencing. Prosecutors from the Justice Department’s Fraud Division and the Eastern District of Louisiana handled the case.

What You Can Do

•      Be cautious about unsolicited calls or ads offering free genetic tests. Telemarketing is how the release says patients were found, and a doctor you have never met should not be ordering your tests.

•      Compare your Medicare statements with your calendar. Medicare advises checking that each listed service happened and that the details are right.

•      To report suspected fraud, call 1-800-MEDICARE (1-800-633-4227) or the inspector general’s tip line at 1-800-HHS-TIPS.

Sources:

•      U.S. Attorney’s Office, Eastern District of Louisiana, “New Orleans Man Sentenced To $7 Million In Restitution For Health Care Fraud Conspiracy” (Oct. 21, 2026)

•      Medicare.gov, “Reporting Medicare fraud and abuse”

HHS Office of Inspector General, “Report fraud”