Physician Assistant Is Indicted For Role In $10 Million Medicare Fraud Scheme
CHARLOTTE, N.C. – A physician assistant is facing federal charges for his role in a genetic testing scheme that resulted in the submission of more than $10 million in fraudulent claims to the Medicare program, announced Dena J. King, U.S. Attorney for the Western District of North Carolina. Colby Edward Joyner, 34, of Monroe, N.C. is charged with one count of health care fraud and six counts of making false statements relating to health care matters.
Robert R. Wells, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division, and Tamala Miles, Special Agent in Charge with the Department of Health and Human Services, Office of Inspector General (HHS-OIG), join U.S. Attorney King in making today’s announcement.
According to allegations contained in the indictment, during 2018 and 2019, Joyner was a physician assistant in the Charlotte area who worked as an independent contractor for a physician staffing and telemedicine company. During the relevant time frame, Joyner allegedly signed fraudulent prescriptions for medically unnecessary genetic testing, specifically cancer genomic and pharmacogenetic testing, for hundreds of Medicare beneficiaries residing in North Carolina.
The indictment alleges that Joyner’s prescriptions resulted in the submission of fraudulent reimbursement claims to the Medicare program in excess of $10 million. As alleged in the indictment, Joyner had never met, seen or treated these beneficiaries, and had only had brief telephone conversations with them, or no interactions with them whatsoever.
The indictment further alleges that Joyner falsified medical records in connection with these prescriptions to conceal that he was not the treating physician and that he did not conduct medical evaluations or examinations, and that he falsely certified that the genetic tests were medically necessary. According to allegations in the indictment, contrary to his claims, Joyner had neither pre-existing provider-patient treatment relationships with, nor plans to pursue further care for, the Medicare beneficiaries. Joyner allegedly did not perform medical evaluations or examinations and had little to no interaction with the beneficiaries before prescribing the genetic tests. Instead, Joyner allegedly received from the telemedicine company and its clients pre-populated prescription forms and related records for patients who were pre-selected for genetic testing, which he then electronically signed and returned, in exchange for $12—and later $15—for each purported consultation that he performed.
The charges contained in the indictment are allegations and the defendant is innocent until proven guilty beyond reasonable doubt in a court of law.
The health care fraud charge carries a maximum prison term of 10 years and a $250,000 fine. The charge of making false statements relating to health care matters carries a maximum penalty of five years in prison and a $250,000 fine, per count.
The investigation was handled by the FBI and HHS-OIG.
Assistant U.S. Attorneys Katherine Armstrong and Matthew Warren of the U.S. Attorney’s Office in Charlotte are prosecuting the case.