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DOJ Indicts Lab Owners in Alleged Conspiracy to Fraudulently Bill Medicare $107M

NEW YORK – The US Department of Justice said on Monday it is charging three individuals for allegedly conspiring to defraud the US through healthcare kickbacks resulting in the submission of $107 million in false and fraudulent genetic testing claims to Medicare.

In an unsealed superseding indictment, the DOJ has charged John Grisham of Hickory Creek, Texas, Rob Wilburn of San Antonio, and Richard Speights Jr., as well as their co-conspirators, in the alleged conspiracy. According to the department, the defendants owned and operated Trinity Clinical Laboratories, a genetic testing lab, located in Lewisville, Texas. Between January 2018 and October 2019, the defendants offered kickbacks and bribes in return for DNA specimens and corresponding prescriptions from thousands of Medicare beneficiaries.

Trinity Clinical Lab then fraudulently billed Medicare and Medicare Advantage for genetic testing. The defendants used "sham contracts" for purported marketing and other services to cover their plan. As a result, Medicare reimbursed the lab about $44 million for the fraudulent claims, the DOJ said.

The defendants are charged with one count of conspiracy to defraud the US and to pay and receive kickbacks and bribes. Additionally, Grisham and Wilburn were also charged with six counts, and Speights Jr. was charged with two counts of paying and receiving healthcare kickbacks. Each could face 10 years in prison for each count of paying and receiving healthcare kickbacks and bribes, and five years in prison on the conspiracy count.