Two men from Texas and Florida were sentenced today to four years and two years in prison, respectively, for their roles as leaders of a marketing company that solicited Medicare beneficiaries for medically unnecessary genetic testing.
The Florida man received an additional two years in prison, to be served concurrently, for his role in falsifying the ownership information in Medicare enrollment documentation for a clinical laboratory.
According to court documents, Paul Wexler, 56, of Spring, Texas, and Paul Bleignier, 64, of Seminole, Florida, operated a telemarketing company that recruited Medicare beneficiaries for cancer genetic (CGx) testing that was medically unnecessary.
CGx testing utilises DNA sequencing to identify mutations in genes that may indicate a higher risk of developing certain types of cancer in the future. It is not a method of diagnosing whether an individual presently has cancer, and Medicare covers CGx testing in limited circumstances.
Further, Wexler, Bleignier and their co-conspirators solicited and received kickbacks in exchange for referring Medicare beneficiaries for CGx testing that was not eligible for Medicare reimbursement.
Through the scheme, Wexler and Bleignier caused Medicare to be billed $17.3 million, and they received $5.2 million in payment.
While the criminal case for genetic testing fraud was pending, Bleignier opened a clinical laboratory and enrolled it in the Medicare programme.
Medicare requires a certification listing anyone with 5% or more ownership interest, but Bleignier used other people’s identities to disguise his involvement.
Kickbacks further tainted the claims related to that laboratory. Bleignier and his co-conspirators billed Medicare for $3,012,156 in claims that were ineligible for reimbursement, and they received $916,106 in payment.
In April 2024, Wexler pleaded guilty to conspiracy to commit health care fraud and wire fraud. In November 2022, Bleignier pleaded guilty to conspiracy to defraud the United States and to pay and receive kickbacks.
In November 2024, he pleaded guilty to making false statements related to healthcare matters.
At sentencing the two were ordered to pay $1.2 million in forfeiture each and $5.2 million in restitution. Bleignier was ordered to pay an additional $916,106 in forfeiture for his role in falsifying the ownership information in Medicare enrollment documentation.
