By SDCN Editor
A superseding indictment was unsealed Friday charging two Texas men and a Louisiana man for conspiracy to defraud the United States, and to pay and receive health care kickbacks, resulting in the submission of over $107 million in false and fraudulent genetic testing claims to Medicare, according to federal prosecutors.
According to court filings, 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 co-conspirators, were allegedly responsible for the submission of at least $107 million in genetic testing claims to Medicare and Medicare Advantage as the result of a sophisticated and nationwide health care kickback scheme.
The men allegedly owned and operated a genetic testing laboratory, Trinity Clinical Laboratories LLC, located in Lewisville, Texas. From January 2018 through October 2019, in exchange for kickbacks and bribes, Grisham, the chief executive officer, Wilburn, the chief financial officer, Speights Jr., a co-owner, and their co-conspirators, allegedly acquired thousands of Medicare beneficiaries’ DNA specimens and corresponding prescriptions that Trinity Clinical Laboratories used to fraudulently bill Medicare and Medicare Advantage for genetic testing. To conceal the nature of the kickback payments, the defendants and their co-conspirators allegedly utilized sham contracts for purported marketing and other services. During the same time frame, Medicare allegedly reimbursed Trinity Clinical Laboratories approximately $44 million based on the fraudulent claims submitted due to the men’s payment and receipt of kickbacks and bribes.
The defendants are charged with one count of conspiracy to defraud the United States and to pay and receive kickbacks and bribes. Grisham and Wilburn are each charged with six counts, and Speights Jr. is charged with two counts of paying and receiving health care kickbacks and bribes.
If convicted, the defendants face 10 years in prison on each count of paying and receiving health care kickbacks and bribes and five years in prison on the conspiracy count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Federal authorities are investigating the case, which was brought as part of Operation Double Helix, a federal law enforcement action led by the Health Care Fraud Unit of the Criminal Division’s Fraud Section, in partnership with the U.S. Attorneys’ Offices for the Southern District of Florida, Middle District of Florida, Southern District of Georgia, Eastern District of Louisiana, Middle District of Louisiana, District of New Jersey, and Northern District of Texas.