Recent Enforcement Actions Target Two Healthcare Fraud Schemes Totaling Over $180M
By the Constantine Cannon Whistleblower Team
The government is committed to cracking down on healthcare fraud schemes as evident in two recent sentencing announcements involving more than $180 million in losses.
Missouri Resident Sentenced to Prison for $174M Healthcare Fraud Conspiracy
A court sentenced Missouri resident Jamie P. McNamara to 10-years in prison on October 23 for orchestrating a scheme to defraud Medicare by unlawfully billing hundreds of millions of dollars for medically unnecessary cancer and cardiovascular genetic testing.[1]
McNamara operated several laboratories in Louisiana and Texas and obtained doctors’ orders for genetic testing through telemarketers and call centers that persuaded Medicare beneficiaries to consent to testing.[2]
According to the government, McNamara paid illegal kickbacks and bribes to secure the orders and concealed those payments through sham contracts.[3]
The genetic testing orders were signed by telemedicine doctors who were not the beneficiaries’ treating physicians, did not consult with them, and did not provide follow up care after the tests.
McNamara also shifted billing between his laboratories to evade Medicare and law enforcement scrutiny and concealed his ownership by falsely listing family members as owners and representatives on official documents.
Over approximately 18 months, McNamara’s laboratories submitted more than $174 million in genetic testing claims to Medicare and received over $55 million in reimbursements. The government previously seized more than $7 million from bank accounts and luxury vehicles connected to the scheme.
While on pretrial release, McNamara violated his bond conditions by fleeing from an unrelated arrest and removing his ankle monitor. He was later detained and pleaded guilty to conspiracy to commit healthcare fraud.[4]
Pharmacist Sentenced to Prison for $6M Healthcare Fraud Scheme
In December 2025, the government announced that Michigan pharmacist Isaiah Okoh was sentenced to 80 months in prison for defrauding healthcare benefit programs. Okoh operated the scheme through three Michigan pharmacies where he billed for prescription medications that he never dispensed.[5]
From 2019 to 2022, Okoh and a co-conspirator submitted false claims to healthcare benefit programs for prescription drugs physicians never ordered and pharmacies never distributed to patients. To conceal the scheme, Okoh and his co-conspirator forged prescriptions. The scheme caused over $6 million in losses to Medicare, Medicaid, and Blue Cross and Blue Shield of Michigan.
In April 2025, Okoh pleaded guilty to one count of conspiracy to commit healthcare fraud. The court ordered him to pay $3,889,760 in restitution and $3,230,147 in forfeiture, including interest in roughly $1.2 million in fraudulent proceeds seized by law enforcement.
Healthcare Fraud Whistleblowers
Healthcare fraud, specifically Medicare billing fraud, remains the most frequent target of the government’s False Claims Act enforcement efforts.
Although it is not known whether whistleblowers were involved in either of these cases, whistleblowers are often responsible for exposing healthcare fraud by bringing misconduct to the government’s attention.
The False Claims Act
Under the qui tam provisions of the False Claims Act, private parties may bring lawsuits on behalf of the government against those that commit fraud against the government. Successful whistleblowers can receive up to 30% of the monetary recovery.
Constantine Cannon attorney Dan Noel explained: “Healthcare fraud schemes that involve kickbacks or unnecessary care put profits ahead of patients. Combating healthcare fraud helps ensure that taxpayer dollars go to care, not corruption.”
Our Firm Helps Healthcare Fraud Whistleblowers
To learn more about blowing the whistle on healthcare fraud or if you believe you have a case, please contact us for a free and confidential consultation with a member of our whistleblower team.
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Sources:
[1] https://www.justice.gov/opa/pr/missouri-man-sentenced-10-years-prison-174m-health-care-fraud-conspiracy
[2] Id.
[3] Id.
[4] Id.
[5] https://www.justice.gov/opa/pr/pharmacist-sentenced-over-six-years-prison-6m-health-care-fraud-scheme
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