TUSCALOOSA, Ala. – Two people pleaded responsible to expenses at the moment in associated instances involving multi-million-dollar well being care fraud conspiracies, introduced U.S. Lawyer Prim F. Escalona, Federal Bureau of Investigation Appearing Particular Agent in Cost Felix A. Rivera-Esparra, and U.S. Division of Well being and Human Companies, Workplace of Inspector Normal, Particular Agent in Cost Tamala E. Miles.
James Ewing Ray, 51, of Gadsden, pleaded responsible earlier than Chief United District Court docket Decide L. Scott Coogler to 1 rely of conspiracy to commit well being care fraud. Ray owned Integrity Medical, LLC, an organization via which he marketed well being care gadgets and companies to medical suppliers. Based on his plea settlement, between 2012 and 2018, Ray conspired with others to pay and obtain kickbacks to induce medical suppliers to subject medically pointless prescriptions and order medically pointless items and companies, which had been then billed to Medicare and different well being insurers. A kind of companies was electro-diagnostic testing supplied by a Huntsville-based electro-diagnostic testing firm referred to as QBR, or Diagnostic Referral Group. Ray acquired per-patient funds from QBR for inducing medical suppliers to order assessments from QBR.
John Hornbuckle, 52, of Huntsville, additionally pleaded responsible earlier than Chief United States District Court docket Decide L. Scott Coogler to 1 rely of conspiracy to commit well being care fraud and one rely of conspiracy to obtain kickbacks. Between 2012 and 2018, Hornbuckle owned QBR. Based on the plea settlement in Hornbuckle’s case, QBR billed insurers thousands and thousands of {dollars} for electro-diagnostic testing that its technicians carried out, no matter whether or not there was a medical want for them. Hornbuckle induced QBR to pay medical suppliers a per-patient payment for the assessments they ordered from QBR that had been reimbursed by insurers, together with Medicare and different authorities well being care applications. The funds had been disguised as hourly funds for the supplier’s time and the time of the supplier’s workers, however the supplier was truly paid a payment per affected person who acquired a check.
The Ray and Hornbuckle instances are associated to a different case that resulted in convictions earlier this yr. After a multi-week trial in February, a jury convicted a Tennessee physician and his spouse of kickback and well being care fraud expenses (amongst others). Dr. Mark Murphy, 65, and his spouse Jennifer Murphy, 65, each of Lewisburg, Tennessee, owned and operated North Alabama Ache Companies, which closed its Decatur and Madison workplaces in early 2017. Based on court docket paperwork and proof introduced at trial, the Murphys took kickbacks from QBR of greater than 1,000,000 {dollars}. In return, Dr. Murphy ordered electro-diagnostic assessments from QBR for his sufferers, no matter whether or not there was a medical want for these assessments. Earlier than the Murphys went to trial, a co-defendant, Brian Bowman, 41, of Attalla, pleaded responsible to well being care fraud conspiracy. Based on Bowman’s plea settlement, Bowman marketed QBR’s electro-diagnostic testing to medical suppliers, and was paid a payment for every check they ordered. Bowman acquired almost 1,000,000 {dollars} in charges from QBR. Dr. Murphy, Jennifer Murphy, and Brian Bowman are all awaiting sentencing.
The utmost penalty for kickback conspiracy is 5 years in jail. The utmost penalty for well being care fraud conspiracy is ten years in jail.
Sentencing dates for Ray and Hornbuckle haven’t but been scheduled.
The FBI and HHS-OIG investigated the case. Assistant U.S. Attorneys J.B. Ward and Don Lengthy are prosecuting the case.
