A Middle Tennessee health care company is accused by federal regulators of a fraudulent billing scheme targeting seniors for unnecessary cancer screenings. The criminal charges are part of a multi-year crackdown on the use of pricey genetic testing.
There are limited legitimate uses for these new $6,000 tests to screen patients for genetic cancer risks, and the Medicare program only pays if the patient already has cancer — usually to determine the course of treatment. When Medicare denies the claim, the patient can be left to pay the bill.
But federal investigators say Crestar Labs in Spring Hill was trying to sign up anyone who’d listen. Owner Fadel Alshalabi is charged with paying kickbacks to marketers who would sign up patients in nursing homes or senior health fairs. The marketing team would even take the oral swab for genomic sequencing.
The company would then pay doctors to place the orders so Medicare would reimburse the charges. According to court documents filed Friday, Crestar usually didn’t perform the tests itself. It tried to bill more than $86 million and was paid $14 million.
People caught in similar schemes have received prison time, though the Crestar case has not yet been heard in court.
Alshalabi, who lives in Charlotte, N.C., was arrested in Chicago over the weekend. His attorney, Brian Rafferty of the law firm Polsinelli, tells WPLN News he’s “disappointed” that the government decided to bring charges and that he and his client have been turning over documents requested by the government for more than a year.