A Massachusetts doctor indicted for her role in an international telemedicine kickback scheme is wrapped up in another legal setback, agreeing to plead guilty to allegedly defrauding Medicare for genetic testing services she never provided.

Le Thu, a Boston-based emergency medicine physician, is accused of causing third-party laboratories to submit roughly $35.5 million in claims to Medicare based on orders for genetic testing that allegedly contained false medical documentation.

Medicare paid about $25.3 million, Massachusetts US Attorney Leah Foley’s office said Friday.

Thu, 69, has agreed to plead guilty to two counts of making false statements relating to health care matters, a charge that carries a sentence of up to five years in prison, three years of supervised release, and a fine of up to $250,000.

Charging documents allege that Thu “knowingly and willfully engaged in a scheme to deceive the Medicare Program in connection with payments for genetic testing for beneficiaries,” between March 2017 and November 2020.

The alleged scheme involved either Thu signing “false medical documentation and orders” or having others who lacked medical training complete and submit the paperwork for “beneficiaries’ genetic testing, which was generally not covered by Medicare.”

The deceitful practice made it appear that Thu was “providing legitimate services,” Foley’s office said in a release.

“Thu allegedly signed or caused these orders to be signed that falsely claimed she had consulted with beneficiaries,” the release states, “conducted examinations prior to ordering genetic testing, obtained consent, and/or would use the testing results to treat the beneficiaries.”

“However,” the release continues, “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.”

Thu allegedly stated in one order that the test results would “determine [a] patient’s medical management and treatment decision,” prompting a third-party lab to bill Medicare for over $24,052, according to charging documents.

In December 2021, Thu was indicted on one count of conspiracy to commit health care fraud and one count of conspiracy to violate the federal Anti-Kickback Statute. The international telemedicine healthcare fraud and kickback scheme, involving “compound medications and durable medical equipment,” included Thu and three “high-level” employees of a telemedicine company, according to the then US Acting Attorney for New Jersey.

That scheme caused roughly $37 million in losses to TRICARE, Medicare and private health insurance companies.