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North Carolina -- July 20, 2022: According to Dena J. King, U.S. Attorney for the Western District of North Carolina,
a physician assistant is currently being investigated by the federal government
for his involvement in a genetic testing scheme that led to the submission of over $10 million in false claims to the Medicare program. Six counts of making false statements about medical issues and one count of health care fraud are brought against Colby Edward Joyner, 34, of Monroe, North Carolina.
The announcement is made today by U.S. Attorney King along with Tamala Miles, Special Agent in Charge with the Department of Health and Human Services, Office of Inspector General (HHS-OIG), and Robert R. Wells, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division.
The indictment makes claims that Joyner worked as an independent contractor for a physician staffing and telemedicine organization in the Charlotte area in 2018 and 2019 as a physician assistant. Joyner is accused of having authorized fraudulent prescriptions for hundreds of Medicare recipients living in North Carolina throughout the relevant time period for genetic testing that was medically unwarranted, including cancer genomic and pharmacogenetic testing.
According to the indictment, Joyner's prescriptions caused the Medicare program to receive over $10 million in false reimbursement claims. According to the indictment, Joyner had never met, seen, or treated these beneficiaries and had only spoken with them on the phone a few times or not at all.
The indictment also claims that Joyner fabricated medical records related to these prescriptions in order to hide the fact that he was not the treating physician, that he had not performed medical evaluations or examinations, and that he had falsely attested that the genetic tests were required for medical reasons. Contrary to what he claimed, Joyner allegedly had neither plans to continue providing care for the Medicare beneficiaries nor any prior provider-patient treatment ties with them. Before recommending the genetic testing, Joyner allegedly did not conduct medical examinations or evaluations and interacted with the recipients scantly at all. Instead, Joyner allegedly received pre-filled prescription forms and related records for patients who were already pre-selected for genetic testing from the telemedicine company and its clients, which he then electronically signed and returned, in exchange for $12—and later $15—for each purported consultation that he allegedly performed.
The indictment makes allegations, and the defendant is presumed innocent until and unless he or she is proven guilty in court beyond a reasonable doubt.
The maximum sentence for the crime of health care fraud is ten years in jail and a fine of $250,000. The maximum punishment for making false statements about medical issues is five years in prison and a $250,000 fine, per offence.
The investigation was handled by the FBI and HHS-OIG.
Assistant U.S. Attorneys Katherine Armstrong and Matthew Warren of the U.S. Attorney’s Office in Charlotte are prosecuting the case.
