In a conspiracy that spanned from the Houston area to rural Kentucky, a Texas-based doctor and his associates are facing charges of conspiracy to commit Medicare fraud charges related a series of kickbacks and false billing claims.
All told, the scheme involved an alleged $470,000 in kickbacks related to urine testing referrals from the doctor to the owner of the Texas laboratory involved in the scheme. If convicted, the penalties for all parties involved could include up to five years in federal prison per offense.
The conspiracy was fairly complex. Doctor Ghyasuddin Syed owned and operated a pain management clinic. The clinic was in a building owned by Syed and operated by his wife Shazan Behum.
Allegedly beginning in 2014, this conspiracy also included Texas businessman Uday Shah. Shah was the owner of a series of drug-testing labs located in Texas, Kentucky, Ohio, and Nevada.
The conspiracy allegedly involved Syed referring out urine tests to labs owned by Shah for testing. In exchange for this business, Shah made cash payments to Syed in a variety of ways. One of the methods used in the scheme involved Shah renting laboratory space in the building owned by Syed. Shah then used these rent payments in an effort to disguise the kickbacks. According to federal authorities, the space in Syed's building was not used as a lab by Shah, and the conspirators moved equipment into the building so that it would appear to be legitimate when federal investigators sought to interview the doctor.
To date, both Shah and one of his associates have pleaded guilty to their role in the crime. The associates of Shah also allege that much of the testing ordered by Syed and performed by Shah was unnecessary, resulting in fraudulent Medicare claims.
Federal Laws Related to Kickbacks and Medicare
There are two different statutes prosecutors could rely on to pursue federal charges related to kickbacks. The first is known as the False Claims Act. The second is referred to as the Anti-Kickback Statute
False Claims Act
The False Claims Act was enacted to prevent government contractors from submitting false medical claims. This statute is used in a variety of ways to prosecute healthcare providers that submit false claims or utilize false medical records in an effort to defraud the government. Offenses under this statute must be committed knowingly, which means billing mistakes or other errors are not criminal. This statute can apply to kickbacks when they involve payments for fraudulent claims. A skilled Houston federal defense lawyer could help a medical professional establish that a filing was a clerical error instead of an attempt to defraud Medicare.
A conviction under the False Claims Act could carry as much as 5 years in federal prison and a fine of $250,000.
The Anti-Kickback Statute targets kickbacks in the medical field specifically. Anything of value given in an effort to steer business to a specific medical provider or vendor can qualify under the statute. A conviction also carries up to 5 years in prison.
These are serious crimes that can lead to serious penalties. Always consult with a skilled Houston federal crimes defense lawyer to understand the charges and for guidance on how to move forward.