Medicare fraud allegations lead to $500,000 settlement

Dr. Kathy Cornelius, a former Wilmingtn physician who now resides in Huntsville, AL, has agreed to pay $500,000 to resolve allegations that she violated the False Claims Act by ordering medically unnecessary genetic testing for Medicare beneficiaries living in Delaware. Cornelius did not admit guilt.

According to the Delaware U.S. Attorney’s office, between October 2020 and February 2022, Cornelius referred more than 250 Delaware residents for medically unnecessary genetic tests that were paid for by Medicare.  The United States alleged that Cornelius had no medical relationship with these patients and that the referrals were based on brief telemedicine consultations – often two minutes or less during which Cornelius failed to establish any legitimate medical justification for the tests. 

The genetic tests Dr. Cornelius ordered often cost thousands of dollars per patient.

 “Doctors who refer patients for medically unnecessary services such as genetic testing drain vital funds from Medicare and other government healthcare programs,” said Delaware U.S. Attorney David Weiss.  “This office will continue to use all available means to identify healthcare providers who increase costs through unnecessary procedures and to hold them accountable.” 

 “Accurately billing for services provided to Medicare beneficiaries is required of all health care providers,” said Maureen R. Dixon, special agent in charge for the U.S. Department of Health and Human Services, Office of the Inspector General, Region III. “HHS-OIG and the U.S. Attorney’s Office will continue to evaluate and pursue allegations of medically unnecessary services”.

The case was handled by Assistant U.S. Attorney Dylan J. Steinberg and Affirmative Civil Enforcement Auditor David Cheung.

Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800‑HHS‑TIPS (800-447-8477).