A substitute indictment was unveiled today charging two Texas men and a Louisiana man with conspiracy to defraud the United States and to pay and receive health care kickbacks, resulting in the filing of more than $107 million in false and fraudulent genetic test claims to Medicare.
According to court documents, John Grisham, 49, of Hickory Creek, Texas, Rob Wilburn, 51, of San Antonio, Texas, and Richard Speights Jr., 52, of Lake Charles, Louisiana, and their accomplices, allegedly were responsible for filing at least $107 million in Medicare and Medicare Advantage genetic testing claims as a result of a sophisticated, nationwide health care kickback program.
The defendants allegedly owned and operated a genetic testing laboratory, Trinity Clinical Laboratories LLC, located in Lewisville, Texas. From January 2018 to October 2019, in exchange for kickbacks and kickbacks, Grisham, the CEO, Wilburn, the chief financial officer, Speights Jr., a co-owner, and their co-conspirators, allegedly acquired thousands of Medicare beneficiaries DNA samples and related prescriptions that Trinity Clinical Laboratories used to fraudulently bill Medicare and Medicare Advantage for genetic testing. To conceal the nature of the bribe payments, the defendants and their accomplices allegedly used fictitious contracts for alleged marketing and other services. During the same time frame, Medicare allegedly reimbursed Trinity Clinical Laboratories about $44 million based on fraudulent claims filed as a result of the defendants paying and receiving kickbacks and kickbacks.
All three defendants are charged with conspiracy to defraud the United States and with paying and receiving kickbacks and kickbacks. Grisham and Wilburn are each charged with six counts and Speights Jr. is charged with two counts for paying and receiving health care kickbacks and kickbacks. If convicted, the defendants face 10 years in prison for each charge of paying and receiving health care kickbacks and kickbacks, and five years in prison for conspiracy. A federal district court judge will determine any sentence after considering U.S. sentencing guidelines and other legal factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Criminal Division of the Justice Department; US Attorney Leigha Simonton for the Northern District of Texas; Special Agent in Charge Jason Meadows of the Dallas Region Office of the Inspector General of the United States Department of Health and Human Services (HHS-OIG); Special Agent in Charge James Dwyer of the FBI Dallas Field Office; Chief William Marlowe of the Texas Attorney General’s Office of Medicaid Fraud Control Unit (TX-MFCU); Chief Inspector Thomas Noyes of the Fort Worth Division of the United States Postal Inspection Service (USPIS); Special Agent in Charge Christopher Altemus of the Internal Revenue Service Criminal Investigation (IRS-CI) Dallas Field Office; and Regional Director Deborah L. Perry of the Dallas office of the US Department of Labor’s (DOL) Employee Safety Administration made the announcement.
HHS-OIG, FBI, TX-MFCU, USPIS, IRS-CI and DOL are investigating the case, which was initiated as part of Operation Double Helix, an action by forces of federal order led by the Fraud Section Criminal Division Healthcare Unit, in cooperation with the U.S. Attorneys’ Offices for the Southern District of Florida, the Central District of Florida, the Southern District of Georgia, the Eastern District of Louisiana, the Central District of Louisiana, the District of New Jersey and the Northern District of Texas.
Trial attorneys Carlos A. López and Lee Hirsch from the Fraud Section of the Criminal Division are pursuing the case.
The Fraud Section leads the Criminal Justice Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force program. Since March 2007, this program, made up of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively billed the Medicare program more than $19 billion. Additionally, the Centers for Medicare and Medicaid Services, in cooperation with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information is available at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
An indictment is just an accusation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in court.