A patient wrote “COVID test only” on her intake form, and Arrayit ran an allergy test on her blood anyway, then billed her insurance company $5,300 (more than many Americans pay in monthly rent) for a test she explicitly refused.

The Con in a Lab Coat

Mark Schena ran Arrayit out of Northern California with his wife, family members, and friends. The company started by selling equipment to other labs. Then Schena, described in court documents as having an “obsession” with medical billing codes, spotted a different kind of opportunity: he could bill insurance companies up to $10,000 (nearly four months of groceries for an average American family) per patient for a full suite of blood allergy tests. The tests cost Arrayit a small fraction of that amount.

The science behind the scheme was, at best, dubious. Allergists use blood tests as a secondary measure when skin tests cannot be performed. Schena marketed his blood tests as superior, despite the fact that they could detect only whether a patient had been exposed to an allergen, not whether that patient actually had an allergy. Arrayit tested every patient for 120 allergens, the maximum its machine could process, regardless of whether those tests had any medical relevance to the patient.

The court record is explicit: Arrayit tested for 120 allergens “not because this was medically necessary (some of the tested allergens were rare), but because it was the most its machine could process.” For most patients, the full 120-allergen test was not warranted. This was a billing strategy dressed in the language of medicine.

They Hunted the Doctors Who Didn’t Know Better

To keep patient samples flowing into Arrayit’s lab, Schena built a marketer network paid entirely on commission: a percentage of the revenue they brought in, with no salary and no written contracts. These marketers were explicitly directed to avoid allergists because, as court testimony confirmed, allergists “didn’t believe in the tests.” Instead, Schena’s team targeted chiropractors, naturopaths, and other practitioners with limited allergy expertise.

Marketers told these less-experienced doctors that Arrayit’s blood testing was “highly accurate” and “far superior” to skin tests. Both claims were false. The blood tests Arrayit used could not determine whether a patient had an allergy. Marketers also “controlled” which lab blood samples were sent to, according to testimony from Marc Jablonski, the lead marketer who later pleaded guilty to conspiring to defraud the United States through kickbacks.

Schena’s financial incentives ensured that marketers pushed blood tests exclusively. A second marketer testified that Arrayit’s commission structure guaranteed marketers would never mention skin testing as an option to doctors, because skin tests generate no billing revenue for a blood lab.

When the Pandemic Hit, He Made It Worse

When COVID-19 kept patients home and Arrayit’s blood sample volume collapsed, Schena pivoted to COVID testing. He deployed the same playbook. The PCR test was the “gold standard” for detecting active COVID infections. Schena used an antibody blood test instead, which could detect past exposure but could not detect an active infection. His marketers told doctors the Arrayit COVID test was equal to, or better than, PCR. That was a lie.

Schena also directed marketers to lie about how quickly COVID results would be available. Speed of results is a critical factor in pandemic-era testing decisions. Doctors and patients chose Arrayit under false pretenses about what the test could do and when they would know.

Then came the most audacious part of the scheme. To revive the lucrative allergy billing business, Schena instructed marketers to bundle allergy tests with every COVID test. His marketers falsely told doctors that, according to Dr. Anthony Fauci, COVID and allergies could be confused, making it medically necessary to test for both simultaneously. Dr. Fauci said no such thing. When doctors ordered only a COVID test, Schena directed lab employees to run the allergy test on that blood sample anyway, without the doctor’s or patient’s authorization.

The Patient Who Said No and Got Billed Anyway

The clearest evidence of how little patient consent meant to Arrayit: one patient explicitly wrote “COVID test only” on her intake form. Arrayit ran an allergy test on her blood regardless. The company then billed her insurance company $5,300 (roughly what a minimum-wage worker earns in three months) for a test the patient had not agreed to and did not know was being run.

This was the operation at its most naked: a patient’s explicit written refusal, ignored; a patient’s insurance account, raided for thousands of dollars; and a lab employee carrying out a direct order from the top of the company to run tests no one authorized.

The Non-Financial Ledger: What the Numbers Can’t Capture

Every dollar figure in this case describes a transaction. What it cannot describe is the experience of being a patient who walked into a doctor’s office for allergy care and left as a revenue unit inside a fraud scheme. The doctors who referred patients to Arrayit were themselves victims of manipulation: Schena’s marketers deliberately selected practitioners who lacked the specialized knowledge to question the blood test claims. These were doctors who trusted the information they received. That trust was systematically exploited.

Arrayit’s marketers “controlled” which lab blood samples went to, according to direct trial testimony. That word, “controlled,” carries enormous weight. It means the decision about where a patient’s bodily sample went, and what tests would be run on it, was made by a commission-paid salesperson, not a physician, not a patient, and certainly not anyone with the patient’s health interests at heart. The doctor’s referral was, in practice, a formality that Schena’s operation manufactured through deception.

Consider what it means to discover that a blood test was run on your body without your consent. A patient who filled out a form, wrote her wishes clearly, and handed over her blood in good faith had that sample used against her financial interests anyway. The allergy test Arrayit ran on her blood had no medical purpose for her in that moment; it existed to generate a billing code. Her insurer was charged $5,300 (more than a semester of community college tuition for many Americans). Insurance fraud costs translate directly into higher premiums for every policyholder in a pool. Every fraudulent claim filed by Arrayit contributed to the cost of being insured in America.

There is also the specific and concrete harm done to patients’ medical records and care trajectories. A positive or ambiguous result from an allergy blood test that cannot actually confirm whether an allergy exists could prompt follow-up treatment, dietary changes, medication, or anxiety. Arrayit tested patients for 120 allergens regardless of relevance. Some of those allergens were rare. None of the patients consented to being tested for things their bodies had no reason to be tested for. The downstream effects of junk science embedded in a person’s medical record are not hypothetical. They follow patients through future doctor’s visits, insurance applications, and health decisions for years.

Marc Jablonski, the lead marketer, pleaded guilty to conspiring to defraud the United States through kickbacks. He testified against Schena. But his guilty plea is also a record of the work he performed: traveling to doctors’ offices, making false representations to medical professionals, pushing tests he knew were being marketed dishonestly, and earning money for each patient referral he generated. Jablonski was an instrument of the scheme. The patients were its raw material.

The restitution order of more than $24 million (enough to hire 400 registered nurses for a full year) acknowledges that specific financial damage was done to specific parties. But restitution does not compensate for the erosion of trust between patients and the medical testing system, the hours spent by insurers investigating fraudulent claims, or the broader social cost of a scheme that weaponized the COVID-19 pandemic against the healthcare system at the exact moment that system was under maximum strain. Schena launched his COVID allergy-bundling scheme during a public health emergency. The medical infrastructure was overwhelmed. Arrayit added noise, false results, and fraudulent billing to a system that could not afford any of it.

Legal Receipts: The Words They Cannot Walk Back

“Arrayit conducted tests for 120 allergens, not because this was medically necessary (some of the tested allergens were rare), but because it was the most its machine could process. Evidence at trial indicated that for most patients, testing for the full 120 allergens was not warranted.” — U.S. Court of Appeals, Ninth Circuit, United States v. Schena (2025)

“Schena instructed his marketers to pitch the blood tests to ‘naïve’ doctors who lacked allergy experience (such as chiropractors and naturopaths), even though allergists considered skin testing to be superior and 120 allergen tests per person were usually not necessary. Schena’s marketers ‘stayed away from the allergists because they didn’t believe in the tests.'” — U.S. Court of Appeals, Ninth Circuit, United States v. Schena (2025)

“Arrayit marketers falsely claimed that according to Dr. Anthony Fauci, COVID and allergies could be confused, requiring tests for both. If doctors only ordered a COVID test, Schena directed lab employees to run allergy tests anyway. In one case, when a patient wrote on the test form that she wanted a ‘COVID test only,’ Arrayit ran an allergy test as well—and billed her insurance nearly $5,300 for it.” — U.S. Court of Appeals, Ninth Circuit, United States v. Schena (2025)

“An analysis of Arrayit’s billings to Medicare showed that the company billed an average of $5,200 per patient—more than any other laboratory in the country and over $4,000 more than the average laboratory billing per beneficiary.” — U.S. Court of Appeals, Ninth Circuit, United States v. Schena (2025)

“Marketing agents misleadingly told the less sophisticated doctors that Arrayit’s blood testing was ‘highly accurate’ and ‘far superior’ to skin tests, even though Arrayit’s blood tests could not assess whether the patient had an allergy (as opposed to having been exposed to an allergen).” — U.S. Court of Appeals, Ninth Circuit, United States v. Schena (2025)

Societal Impact Mapping

Public Health: A Fraud Designed to Infect the Healthcare System at Its Core

Arrayit’s scheme degraded the relationship between doctors and the diagnostic tools they rely on. When a marketer tells a chiropractor that a blood test is “highly accurate” and “far superior” to the established standard of care, and that doctor believes it and acts on it, the harm travels downstream to every patient that doctor sees. Medical decision-making depends on the accuracy of information. Arrayit systematically poisoned that information supply for practitioners who lacked the specialist background to identify the lie.

The COVID-testing component of the scheme compounded this damage at a uniquely dangerous moment. In 2020, the medical system was operating under catastrophic pressure. Reliable COVID testing was critical to public health decisions, contact tracing, and clinical triage. Arrayit marketed an antibody test that detected past exposure, not active infection, as equivalent to the PCR gold standard. Doctors who trusted that claim made clinical and public health decisions based on false information. The court record does not quantify how many COVID tests Arrayit administered under these false pretenses, but the scheme was active and the scale of the operation was national.

Junk medical data embedded in patients’ records also carries long-term public health consequences. Allergy misdiagnosis can result in unnecessary medication, inappropriate dietary restriction, incorrect treatment protocols, and follow-up care that consumes medical resources. When Arrayit ran 120-allergen panels on patients who did not need them, any ambiguous results from those tests became part of those patients’ permanent medical records. The downstream cost to those individuals’ health and their interactions with the medical system is incalculable from the available source material, but the mechanism for harm is real and documented.

Economic Inequality: The Fraud Tax on Everyone Who Pays for Health Insurance

Healthcare fraud is not a victimless crime against abstract insurance companies. Insurers pass the cost of fraud, including the administrative cost of detecting, denying, and litigating fraudulent claims, directly to policyholders through premium increases and coverage restrictions. Arrayit billed $77 million (roughly equal to the annual health budget of a small American city) in fraudulent claims. Even though insurers denied or reduced most of those claims, the cost of processing, investigating, and contesting them is not free. Those costs flow back into the system.

Schena specifically designed the scheme to exploit private insurance as well as public programs like Medicare. The Ninth Circuit opinion notes that EKRA was designed to extend anti-kickback protections to patients with private insurance, not just those covered by federal programs. This means Arrayit’s targets included working people with employer-sponsored plans, not just Medicare beneficiaries. Every fraudulent claim inflated the cost of operating the private insurance market. That cost is distributed across millions of people who have nothing to do with Arrayit and never will.

The commission structure Schena used for his marketers also illustrates how economic incentives drive healthcare fraud at the ground level. Marketers received no salary, no written contract, and no base pay. Their entire income depended on the revenue they generated by steering patients toward Arrayit. A second marketer testified that this structure guaranteed they would never present skin testing as an alternative, because skin tests generate zero revenue for a blood lab. Schena built a financial system that made honesty economically irrational for every person he employed as a marketer.

What Now: Don’t Look Away

The conviction is real. The prison sentence is real. But the conditions that made Arrayit possible are still real too.

What You Can Actually Do

Request an itemized bill for every medical test you receive. You have the legal right to it. If you see a charge for a test you did not authorize, dispute it in writing with your insurer and report it to your state insurance commissioner and to the HHS-OIG fraud hotline at 1-800-HHS-TIPS. Healthcare fraud thrives on patient silence. Talking to your neighbors, your union, your community health organization, and your local patient advocacy groups about what happened at Arrayit is how systemic problems become systemic pressure.

Connect with patient rights organizations in your state. Mutual aid health networks can help you understand your rights before you ever set foot in a lab. The most powerful thing you can do is know what you agreed to, and refuse everything else in writing.