Georgia Man Sentenced for $7.2M Medicare Genetic Testing Kickback Scheme

A Georgia man, Patrick C. Moore Jr., was sentenced to 46 months in prison and ordered to pay over $7.2 million in restitution for orchestrating a kickback scheme involving medically unnecessary genetic tests for Medicare beneficiaries. Moore instructed a network of recruiters to induce beneficiaries to undergo genetic tests that were either unnecessary, misrepresented, or ineligible for reimbursement, resulting in significant fraudulent Medicare claims. He received approximately $4.3 million in kickbacks for referring beneficiary information, DNA specimens, and fabricated doctor's orders to associated laboratories. The scheme involved laboratories billing Medicare around $24 million for these genetic tests, with approximately $7.2 million paid on claims fueled by illegal inducements. To conceal illicit payments, Moore created sham invoices that falsely documented hours worked instead of acknowledging per-referral kickback payments, violating the Anti-Kickback Statute. Moore pleaded guilty to conspiracy to defraud the United States and to pay and receive illegal health care kickbacks. This case was the result of a joint investigation by the Department of Justice (DOJ), the Health and Human Services Office of Inspector General (HHS-OIG), and the FBI. Prosecutors from the DOJ’s Fraud Section and U.S. Attorney’s Office in the Southern District of Georgia successfully brought the charges. The Fraud Section’s Health Care Fraud Strike Force Program has played a leading role in combating health care fraud across multiple federal districts since 2007. This case underscores ongoing regulatory and enforcement efforts targeting fraudulent activities within Medicare, particularly schemes involving inducements for services that inflate program costs and undermine compliance. Providers engaged in similar practices face increased scrutiny from Centers for Medicare & Medicaid Services (CMS) and HHS-OIG initiatives aimed at enhancing accountability in federal health care programs. The DOJ continues to prioritize health care fraud investigations to protect federal healthcare funds and ensure program integrity.