All but two of the 15 defendants are from Texas with one from New York and one from Pennsylvania.
BEAUMONT, Texas — Two Southeast Texas men have been named in a federal case alleging medical fraud and kickbacks to doctors for lab tests that were often unneeded.
Stephen Kash, of Beaumont, and William Todd Hickman, of Lumberton, were both named in a case brought by the U.S. Department of Justice against them and 13 others according to a news release from the Department of Justice.
All but two of the 15 defendants are from Texas with one from New York and one from Pennsylvania, according to the release.
Among the others named were the CEOs of laboratories True Health Diagnostics and Boston Heart Diagnostics, as well as a small hospital in Rockdale, Texas.
The government is alleging that between at least 2010 and 2018 executives and employees of True Health Diagnostics, where Kash was the Director of Strategic Accounts, and Boston Heart Diagnostics Corporation conspired with several small Texas hospitals to pay doctors to refer patients to the hospitals for testing which were performed by the two labs.
The government is alleging that the hospitals, including Little River Healthcare, in Rockdale and Stamford Memorial Hospital, in Stamford, paid a portion of their laboratory profits to recruiters who paid kickbacks to the referring doctors.
The recruiters allegedly set up companies known as maintenance service organizations, or MSOs, to facilitate paying the doctors.
The complaint says Kash actively recruited doctors for the scheme and that a Lufkin doctor he approached in 2015 said his pitch sounded like a risky get rich quick scam.
The doctor described it as a scheme that “could make an extra million dollars in one year only to go bust two years down the road.”
Hickman also recruited doctors in the scheme using several companies he founded to funnel payments to himself and doctors according to the complaint.
Payments to the referring doctors were disguised as investment returns according to the news release.
Executives and sales employees at the two labs used the kickbacks to doctors to increase lab referrals by the doctors the government alleged. In doing so the executives and sales staff got bigger bonuses and commissions.
Lab tests from the referral scheme were billed to various federal medical programs including Medicare, Medicaid and TRICARE according to the release.
In many cases the referred tests were “not reasonable and necessary.”
Additionally Little River Healthcare falsely billed lab tests as outpatient services which resulted in much larger payments for the tests the release said.
The Justice Department’s complaint is alleging the scheme violated the False Claims Act, the Anti-Kickback Statute and the Stark Law.