New Orleans Man Pleads Guilty to Medicare Fraud Conspiracy
A screenshot from John M. Spivey’s website shows his involvement in healthcare and other business adventures. Spivey pleaded guilty to conspiracy to commit healthcare fraud on July 30.
John M. Spivey, 53, pled guilty to one count of conspiracy in connection with a scheme to bill for medically unnecessary cancer and cardiovascular genetic testing that is ineligible for Medicare reimbursement. The U.S. Attorney said the tests were procured by illegal kickbacks and bribes.
Spivey faces up to 10 years in prison, three years of supervised probation and $250,000 in fines when he is set for sentencing before U.S. District Judge Darrel J. Papillion next April. He was indicted on May 10.
Spivey’s alleged co-conspirator, 48-year-old Jamie McNamara of Lee’s Summit, Missouri, was also indicted on 18 counts of fraud, conspiracy to commit fraud, bribery, money laundering, and conspiracy to commit money laundering. His trial is scheduled for February 2025.
“No-Cost Cancer Test”
From November 2018 through July 2020, McNamara’s laboratories allegedly engaged in aggressive telemarketing schemes designed to mine victims for their Medicare information. One telemarketing script they used informed Medicare beneficiaries that they could receive a “no-cost cancer test.” After getting their Medicare information, McNamara paid doctors to sign off on the tests, which were not medically necessary, according to the indictment.
The U.S. Attorney’s Office also contends the pair submitted over $174 million in fraudulent Medicare claims for genetic testing and received over $55 million in reimbursements. They then allegedly conspired to launder the money. Federal investigators seized $7 million worth of luxury vehicles, according to a May 14 press release.
If convicted of health care fraud and wire fraud, McNamara could receive 20 years in prison, as well as three years of probation and payment of a $250,000 fine. Each of McNamara’s eight healthcare fraud counts carries a maximum of 10 years in prison. Conspiracy to pay and receive kickbacks has a maximum prison sentence of five years. He faces up to 20 years for a count of conspiracy and two of money laundering and 10 years for transactional money laundering offenses.
U.S. Attorney Duane A. Evans emphasized that an indictment is only a charge, not proof of guilt. All defendants are presumed innocent until proven guilty in court.
PLEA AGREEMENT
Spivey agreed to plead guilty to the charge in exchange for a reduced sentence, according to a plea agreement obtained by The Daily Muck. Spivey agreed to plead guilty to one charge of conspiracy to commit healthcare fraud in exchange for the government dropping the other charges in the indictment.
As a consequence of his plea, Spivey faces ten years in prison plus a $250,000 fine. If Spivey had not pleaded guilty, conviction on all charges could have resulted in a maximum of 20 years in prison plus fines and restitution.
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