NHCAA SmartBrief
Businessman pleads guilty in $19M Medicare fraud case
Created for np3kckdy@niepodam.pl | Web Version
 
November 21, 2025
 
 
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Mo. man gets 10-year sentence for $174M genetic testing scheme
Jamie McNamara of Missouri has been sentenced to 10 years in prison for orchestrating a $174 million Medicare fraud scheme involving genetic testing. According to prosecutors, McNamara operated labs in Louisiana and Texas, using telemarketers to obtain illegitimate orders for tests and paying kickbacks to telemedicine doctors. The scheme resulted in $55 million in reimbursements.
Full Story: Department of Justice (11/19)
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Law Enforcement & The Courts
 
2 execs found guilty in $100M distribution, fraud scheme
 
High angle view of tablet computer, stethoscope and pills on turquoise background
(The_burtons/Getty Images)
Ruthia He, founder and CEO of telehealth company Done, and David Brody, clinical president, were convicted of operating a $100 million illegal drug distribution and health care fraud scheme. They filed false reimbursement claims, exploited telehealth rules, spent over $40 million on deceptive advertisements to lure people seeking drugs without prescriptions and used an "auto-refill" feature that issued prescriptions to deceased patients in some instances, according to court records. The scheme led to more than $14 million in payments from Medicare, Medicaid and commercial insurers.
Full Story: KSBW-TV (Salinas, Calif.) (11/20)
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Businessman pleads guilty in $19M Medicare fraud case
Willie De Gibbs, a businessman from Mississippi and Florida, has pleaded guilty to conspiracy to commit health care fraud. He admitted to submitting more than $19 million worth of fraudulent claims to Medicare for unnecessary orthotic braces through three durable medical equipment supply companies after paying kickbacks for doctors' orders, authorities said.
Full Story: WTOK-TV (Meridian, Miss.) (11/20)
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Tools & Technology
 
Ethical challenges of AI in health care discussed
At AMP 2025, bioethicist Takunda Matose, PhD, discussed the ethical considerations of using AI in health care. He emphasized the importance of mindful data usage, addressing inherent biases, and the need for human discretion in AI systems. Matose argued that while AI excels in data analysis, its limitations due to bias and ethical challenges must be acknowledged. He urged stakeholders to consider the broader implications of AI, focusing on patient and stakeholder needs, and to thoughtfully integrate AI into health care systems.
Full Story: Inside Precision Medicine (11/18)
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White House drafts order to block state AI laws
 
WASHINGTON DC, UNITED STATES NOVEMBER 4: The American flag flies at half-staff over the White House in honor of the late Vice President Dick Cheney, in Washington, D.C. (Photo by Celal Güne/Anadolu via Getty Images)
(Anadolu/Getty Images)
The White House is preparing an executive order to block state-level AI laws, aiming to establish a federal standard for AI model reporting and disclosure. This move, supported by tech lobbyists, seeks to prevent a patchwork of state regulations that could complicate compliance. However, it faces opposition from state legislators and legal experts who argue that states have the right to regulate technology within their borders.
Full Story: Politico (11/19)
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