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Call Center Manager Convicted of Role in $67M Genetic Testing Fraud Scheme

NEW YORK – The US Department of Justice said Tuesday that a federal jury has convicted the manager of a Florida call center for his role in a $67 million genetic testing fraud scheme.

According to the government, Jose Goyos and his co-conspirators engaged in deceptive telemarketing calls in which they contacted the primary care physicians of Medicare beneficiaries and tricked them into ordering medically unnecessary genetic tests based on paperwork fabricated by the call center Goyos managed.

Goyos had call center employees falsely represent to providers that the Medicare beneficiaries were “mutual patients” who requested the testing and that they had medical conditions that justified the testing.

Additionally, Goyos and his co-conspirators created “shell” labs that they used to submit the test claims to Medicare while having the actual testing done at outside labs at a fraction of the price they charged Medicare. In many cases, the test results were never sent to the patients’ physicians and were never used in the patients’ care.

According to the charges, between June 2020 and July 2021, Goyos and his co-conspirators submitted more than $67 million of false and fraudulent claims to Medicare, of which Medicare paid $52 million.

The jury convicted Goyos of conspiracy to commit wire fraud and conspiracy to commit money laundering. He is scheduled to be sentenced on Dec. 21 and faces a maximum penalty of 20 years in prison for the conspiracy to commit wire fraud count and 10 years in prison for the conspiracy to commit money laundering count.

To date, 20 other defendants involved in the scheme have pleaded guilty to various charges, the DOJ said.