Ten People, Including 2 Doctors, Indicted In $300 Million Healthcare Kickback Scheme
NORTH TEXAS (CBSDFW.COM) — Officials with the Department of Justice have indicted 10 people, including two medical doctors, in a $300 million healthcare fraud scheme.
The defendants – who stand accused of conspiracy to commit healthcare fraud, conspiracy to pay and receive healthcare kickbacks, offering or paying illegal kickbacks, and soliciting or receiving illegal kickbacks – were charged in a 26-count indictment filed February 9.
"Anti-kickback laws are designed to ensure that financial considerations do not cloud physicians' judgement," said Chad Meacham, the U.S. Attorney for the Northern District of Texas.
According to the indictment, the founders of several lab companies, including Unified Laboratory Services, Laboratory, and Reliable Labs LLC, allegedly paid kickbacks to induce medical professionals to order medically unnecessary lab tests, which they then billed to Medicare and other federal healthcare programs.
The medical professionals allegedly accepted the bribes and ordered millions of dollars' worth of tests.
Meanwhile, Unified, Spectrum, and Reliable disguised the kickbacks as legitimate business transactions, including as medical advisor agreement payments, salary offsets, lease payments, and marketing commissions.
"Illegal kickback schemes corrupt the healthcare system. They cause billions of dollars in losses each year, generate business for dishonest service providers and erode trust in our health care system," said Dallas FBI Special Agent in Charge Matthew DeSarno.
The labs allegedly paid doctors hundreds of thousands of dollars for "advisory services" which were never performed in return for lab test referrals. They also allegedly paid portions of the doctors' staff's salaries and a portion of their office leases, contingent on the number of lab tests they referred each month.
Knowing they could disguise additional kickbacks using a provider-ownership model, the founder of Spectrum and Unified, Jeffrey Madison of DeSoto, convinced the co-founders of Reliable to convert their company into a physician-owned lab. Reliable offered physicians ownership opportunities only if those physicians referred an adequate number of lab tests. In some cases, they made advance disbursement payment to physicians in an effort to appease the physician and ensure he would not send samples to other labs.
As a result of these kickbacks, laboratories controlled by the defendants were able to submit more than $300 million in billing to federal government healthcare programs.
If convicted, the defendants face up to 55 years or more in federal prison.
The Federal Bureau of Investigation's Dallas Field Office assisted other agencies in the investigation.
