Two Laredo, Texas-based physicians were among 10 indicted in a $300 million healthcare fraud scheme Feb. 10, according to the Justice Department.
Five details:
1. Jose Roel Maldonado, MD, a family medicine physician, and Eduardo Carlos Canova, MD, an internal medicine specialist, are among the providers accused of accepting kickbacks from multiple laboratories in exchange for ordering medically unnecessary lab tests.
2. The laboratories, Unified Laboratory Services, Spectrum Diagnostic Laboratory, and Reliable Labs, are accused of disguising kickbacks paid to the physicians as business transactions, including medical adviser agreement payments, salary offsets, lease payments and marketing commissions.
3. The physicians allegedly accepted hundreds of thousands of dollars in the scheme for services that weren't rendered, and other payments were also made contingent on the number of lab tests referred. One of the indicted providers increased referrals from 20 to 30 per day after the lab threatened to end payments without more referrals, according to the Justice Department.
4. Reliable Labs was converted into a physician-owned lab, and ownership opportunities were offered only to physicians who referred a certain number of lab tests, the indictment alleges. Some of the physician owners allegedly received advanced disbursements to secure future referrals as well.
5. Dr. Maldonado received $400,000 in kickbacks for ordering $4 million worth of lab tests, and Dr. Canova received more than $300,00 in kickbacks for ordering $12 million worth of lab tests, the Justice Department alleges.