AUSTIN, Texas – The Office of the Attorney General’s Medicaid Fraud Control Unit (“MFCU”) has arrested Lily Tran Daniel, Kenneth Reynolds, and Lillian Thai, who are associated with the genetic testing company ApolloMDx, for their involvement in a major healthcare fraud scheme to fraudulently bill Medicare approximately $142 million. MFCU and the FBI executed warrants seizing sports cars, a sailboat, and three properties, at a total value of $7.1 million, funded by illegal proceeds of the operation.
ApolloMDx offered illegal kickbacks in order to purchase both recipient information from marketers and orders for genetic testing from doctors. In some cases, doctors made fraudulent diagnoses to make it appear as though recipients were eligible for testing when they were not. In addition, ApolloMDx altered dates of service on testing orders to make it appear that multiple DNA samples were collected on different dates to enable billing for multiple dates of service.
The case was investigated by Sergeant Joyce Combest, Investigative Auditor Wanda Guess, and Captain Rick McCollum from the Texas Medicaid Fraud Control Unit, as well as the Department of Health and Human Services’ Office of Inspector General and the FBI. The U.S. Department of Justice Health Care Strikeforce is prosecuting the case.
Source: Texas AG Medicaid Fraud Unit Dismantles $142M Genetic Testing Fraud / Mega Doctor News