A doctor from Boston has been charged and has agreed to plead guilty in connection with a multi-million-dollar healthcare fraud scheme in which she allegedly defrauded Medicare for genetic testing services she never provided. Le Thu, 69, is charged and has agreed to plead guilty to two counts of making false statements relating to healthcare matters. According to the charging documents, from in or about March 2017 through in November 2020, Thu knowingly and willfully engaged in a scheme to deceive the Medicare Program in connection with payments for genetic testing for beneficiaries. Specifically, Thu allegedly signed and/or caused other individuals who had no medical training to sign and submit false medical documentation and orders for beneficiaries’ genetic testing — which was generally not covered by Medicare — therefore making it appear that Thu was providing legitimate services. Thu allegedly signed or caused these orders to be signed that falsely claimed she had consulted with beneficiaries, conducted examinations prior to ordering genetic testing, obtained consent, and/or would use the testing results to treat the beneficiaries.
However, it is alleged that Thu did not see, speak to, or otherwise communicate, examine or provide any medical services to Medicare beneficiaries in connection with any of the false orders submitted, without regard to whether the beneficiaries needed the genetic testing. It is alleged that in one of the orders, Thu stated, among other things that the test results would “assist [Thu] in making patient-specific clinical decisions” and would “directly impact [Thu’s] patient’s medical management.” In connection with that alleged false order, a third-party laboratory billed Medicare approximately $5,368, for which Medicare paid approximately $2,886. Thu allegedly falsely stated in another order for genetic testing that the results of the testing would “determine [a] patient’s medical management and treatment decision.” In connection with that alleged false order, a third-party laboratory billed Medicare for over $24,052. It is alleged that, as a result of the orders submitted on false medical documentation, Thu caused laboratories to submit approximately $35.3 million in claims to Medicare based on doctors’ orders containing materially false representations, for which Medicare paid approximately $25.3 million.