A Florida telemarketer was sentenced to 15 years in prison for his role in a scheme to defraud Medicare out of $67 million by billing for medically unnecessary genetic testing.
Jose Goyos, 38, of West Palm Beach, was the manager of the so-called "doctor chase" division of a call center, which contacted primary care physicians of targeted Medicare beneficiaries and deceived the providers into ordering medically unnecessary genetic tests based on medical paperwork created by the call center, according to a Dec. 6 Justice Department news release.
Mr. Goyos and his co-conspirators then used the physicians' orders to submit claims to Medicare for expensive and medically unnecessary genetic tests. The results of these tests were often not sent to the beneficiaries and were not used in their treatment.
The scheme took place between May 2020 and July 2021. Of the $67 million in false claims submitted, Medicare paid over $53 million.
Mr. Goyos was sentenced after being convicted by a jury in October of conspiracy to commit wire fraud and conspiracy to commit money laundering. Nine others were previously sentenced for their roles in the scheme.