Illinois Man Admits Role in $4.6 Million Health Care Fraud Related to Genetic Testing
NEWARK, N.J. – An Illinois man today admitted his role in a scheme to defraud the Medicare Program in connection with fraudulent orders for genetic tests, U.S. Attorney Craig Carpenito announced.
Kyle D. McLean, 36, of Arlington Heights, Illinois, pleaded guilty by videoconference before U.S. District Judge Brian R. Martinotti to a superseding information charging him with one count of conspiracy to defraud the United States in connection with a scheme to commit health care fraud. McLean and five co-defendants were previously charged by indictment in September 2019 in connection with the conspiracy and a related scheme.
According to documents filed in this case and statements made in court:
McLean and certain of his conspirators operated Privy Health Inc., a company that acquired DNA samples and Medicare information from hundreds of patients through various methods, including offering $75 gift cards to patients, all without the involvement of a treating health care professional. Privy partnered with another company, Ark Laboratory Network LLC, which purported to operate a network of laboratories that facilitated genetic testing. Matthew S. Ellis, a physician based in Gainesville, Florida, and a co-defendant charged in the indictment, served as the ordering physician who authorized genetic testing for hundreds of patients across the country that he never saw, examined, or treated. These included patients from New Jersey and various other states where Ellis was not licensed to practice medicine. Through this process, Ellis, McLean, and others submitted and caused to be submitted fraudulent orders for genetic tests to numerous clinical laboratories. These orders falsely certified that Ellis was the patients’ treating physician and, in some cases, falsely indicated that a patient had a personal or family history of cancer. In 2018 alone, Medicare paid clinical laboratories at least approximately $4.6 million for genetic tests that Ellis ordered as part of this scheme.
The charge to which McLean pleadedguilty carries a maximum penalty of five years in prison and a fine of $250,000, or twice the gross grain or loss from the offense. Sentencing is scheduled for Oct. 9, 2020.
A co-defendant, Kacey C. Plaisance, of Altamonte Springs, Florida, previously pleaded guilty and is scheduled to be sentenced on September 17, 2020.
U.S. Attorney Carpenito credited the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Scott Lampert; and special agents of the U.S. Attorney’s Office for the District of New Jersey with the investigation leading to today’s guilty plea.
The government is represented by Senior Trial Counsel Bernard J. Cooney of the Health Care Fraud Unit of the U.S. Attorney’s Office in Newark.
The charge and allegations against the remaining defendants are merely accusations, and they are presumed innocent unless and until proven guilty.