FWA MI- Three men charged with millions in Medicare, Medicaid fraud

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[MM Curator Summary]: John, Rob and Richard stole $44M using a kickback scheme to drive revenues for their genetic testing lab.


Clipped from: https://www.upi.com/Top_News/US/2023/01/06/justice-department-charges-fraud-medicare-medicaid/7701673039406/



Jan. 6 (UPI) — Three men have been charged with conspiring to defraud the federal government out of more than $107 million after submitting fraudulent genetic testing claims to Medicare.

A superseding indictment was opened Friday, charging John Grisham and Rob Wilburn, of Texas, and Richard Speights Jr., of Louisiana, the Justice Department said in a release.

The three men allegedly owned and operated a genetic testing laboratory in Lewisville, Texas between January 2018 and October 2019.

They are accused of acquiring thousands of Medicare beneficiaries’ DNA specimens and corresponding prescriptions, which Trinity Clinical Laboratories then used to fraudulently bill Medicare and Medicare Advantage for genetic testing.

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The sophisticated and nationwide health care kickback scheme allegedly netted some $44 million worth of Medicare reimbursements “due to the defendants’ payment and receipt of kickbacks and bribes,” according to the Justice Department.

Following a multi-agency investigation, all three men are now facing one count of conspiracy to defraud the United States and to pay and receive kickbacks and bribes.

Additionally, Grisham, 49, and Wilburn, 51, are each charged with six counts, and Speights Jr.,52, is charged with two counts of paying and receiving health care kickbacks and bribes.

If convicted, the men face 10 years in prison on each count of paying and receiving health care kickbacks and bribes and five years incarceration on the conspiracy count.

The investigation came under the umbrella of the national Health Care Fraud Strike Force Program.

Since March 2007, the program has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion.

In November, the Justice Department charged 10 individuals in multiple states for defrauding healthcare providers, insurance companies, Medicare and Medicaid.

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