Florida Laboratory Owner Pleads Guilty to $52M Medicare Fraud Scheme Involving Genetic Tests

A Florida man pleaded guilty on Jan. 15 for his role in a scheme to defraud Medicare by submitting over $52 million in false and fraudulent claims for genetic testing that Medicare beneficiaries did not need and that were based on prescriptions purchased through illegal kickbacks and bribes. According to court documents, Sean Alterman, 38, of Lake Worth, Florida, owned and operated two laboratories, Live Beyond Medical MGMT, LLC and Dynix Diagnostics LLC, through which he purchased doctors’ orders for expensive genetic testing from patient recruiters. The patient recruiters ran deceptive telemarketing campaigns that targeted Medicare beneficiaries and persuaded them to agree to take the tests to justify the fraudulent billing. As part of the scheme, the patient recruiters used a tactic known as “doctor chasing” – faxing physicians false and misleading requests for prescriptions designed to trick them into signing off on tests their patients did not need. The faxes and accompanying materials falsely stated, among other things, that the prescription requests were made on behalf a mutual patient. But they were generated by call centers that deceived the Medicare beneficiaries to agree to the tests without being examined or treated by physicians for the diseases underlying the tests. Alterman’s laboratories billed approximately $52 million to Medicare for the false and fraudulent claims, of which Medicare paid approximately $36 million. Alterman made roughly $5.5 million from the scheme, much of which he received through shell companies he owned called Shivv LLC and Shank LLC. As part of his plea agreement, Alterman agreed to forfeit his Lake Worth estate and a 2022 Rolls Royce Ghost purchased with money traceable to the scheme: Alterman pleaded guilty to conspiracy to commit health care fraud and conspiracy to offer and pay kickbacks. He is scheduled to be sentenced on April 16 and faces a maximum penalty of 15 years in prison.