Today’s indictment against two Texas men, and one Louisiana man was reopened. They were charged with conspiracy to defraud America and to pay and accept kickbacks in the health care industry. This led to the submission of more than $107 million in fraudulent and false genetic testing claims to Medicare.
Court filings state that John Grisham (49), of Hickory Creek in Texas, Rob Wilburn (51), of San Antonio, Texas and Richard Speights Jr. (52), of Lake Charles, Louisiana were allegedly responsible, as part of a sophisticated, nationwide health care kickback scheme, for the submission of $107 million in genetic testing claims.
Trinity Clinical Laboratories LLC was a genetic testing lab that the defendants owned and operated in Lewisville, Texas. From January 2018 to October 2019, Grisham, Wilburn, the chief executive officer, and Speights Jr., the chief financial officers, allegedly obtained thousands of Medicare beneficiaries’ DNA samples and corresponding prescriptions. These were used by Trinity Clinical Laboratories to fraudulently bill Medicare Advantage and Medicare. The kickback payments were allegedly hidden by the defendants and their conspirators who allegedly used sham contracts to purport marketing and other services. Medicare was allegedly to reimburse Trinity Clinical Laboratories $44 million during the same period based on fraudulent claims submitted by the defendants due to their payment and receipt kickbacks.
The three defendants face one count each of conspiracy to defraud America and to pay and take kickbacks or bribes. Grisham, Wilburn and Speights Jr. are each facing six charges. Speights Jr. faces two counts of receiving and paying health care kickbacks. The defendants could spend 10 years prison for each of the charges of receiving and paying health care kickbacks or bribes, and five years for the conspiracy charge if convicted. After considering all relevant U.S. factors, a federal district court judge will decide the sentence. Sentencencing Guidelines and other factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Leigha Simonton in the Northern District of Texas. Acting Special Agent In Charge Jason Meadows of the U.S. Department of Health and Human Services Office of Inspector General Dallas Region. James Dwyer, Acting Special agent in Charge of the FBI Dallas Field Office. Chief William Marlowe of the Medicaid Fraud Control Unit of the Texas Office of the Attorney General. Thomas Noyes, Inspector in Charge of the U.S. Postal Inspection Service (USPIS), Fort Worth Division; Special agent in charge Christopher Altemus of Internal Revenue Service Criminal Investigations (IRSCI) Dallas Field Office; Acting Special Agent In Charge James Dwyer of the FBI Dallas Field Office; Chief William Marlowe of the Medicaid Fraud Control Unit of the Texas Office of the Attorney General (TX-MFCU); and Inspector in Charge Thomas Noyes of the U.S. Department of Labor.
The case is being investigated by the HHS-OIG and FBI.
The case is being prosecuted by Carlos A. Lopez and Lee Hirsch, Criminal Division’s Fraud Section Trial Attorneys.
The Criminal Division’s Fraud Section is responsible for coordinating the efforts of the Health Care Fraud Strike Force Program to combat fraud in the health care sector. This program, which consists of 15 strike forces operating across 24 federal districts has brought more than 4,200 people to trial. They have collectively billed Medicare for more than $19 million. The Centers for Medicare & Medicaid Services and the Office of the Inspector General for the Department of Health and Human Services are also taking steps to hold healthcare providers accountable for participating in health care fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
An indictment is only an allegation. All defendants are presumed innocent unless proven guilty beyond reasonable doubt in court.
The post Laboratory Executives and Owners Charged with Health Care Kickback Scheme appeared originally on Attorney At Law Magazine.