LEXINGTON — A federal grand jury has returned a 100-count indictment charging five men, who owned a clinical laboratory, with billing health care third-party payors for urine drug tests that were medically unnecessary and not eligible for reimbursement.
On Thursday, a federal grand jury returned an indictment charging Dr. Robin G. Peavler, 54, of Lexington, Ky., Dr. Bryan S. Wood, 48, of Danville, Ky., and Dr. Robert L. Bertram, 47, James W. Bottom, 62, Brian C. Walters, 43, all of Russell Springs, Ky., with one count of conspiracy to commit health care fraud and 99 counts of health care fraud. The alleged conduct was part of a scheme to defraud Medicare, Medicaid, Anthem BlueCross BlueShield, Bluegrass Family Health, and others.
Beginning around December 2010, as alleged in the indictment, the defendants agreed to collect thousands of urine samples for testing at PremierTox, a clinical lab formerly owned by the defendants, which lacked the ability to perform quantitative drug tests on such a high volume of samples.
PremierTox allegedly froze the samples, at a lab in Russell Springs, Ky., and didn’t perform the tests until up to ten months later, knowing that the results were no longer relevant to the treatment of the patients. According to the indictment, the defendants submitted claims to Medicare, Medicaid and private insurers, and were reimbursed thousands of dollars for these unnecessary tests.
Kerry B. Harvey, U.S. Attorney for the Eastern District of Kentucky; Derrick Jackson, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, Atlanta Region; and Jack Conway, Kentucky Attorney General, jointly made the announcement today.
The investigation was conducted by the U.S. Department of Health and Human Services, Office of Inspector General, and the Office of the Kentucky Attorney General’s Medicaid Fraud and Abuse Control Unit. Assistant U.S. Attorney Kate K. Smith is prosecuting this case on behalf of the federal government.
The defendants are scheduled to appear in court on December 1, 2015 at 1:30 p.m. If convicted, the defendants face a maximum of ten years in prison. Any sentence following a conviction, however, would be imposed after the Court considers the U.S. Sentencing Guidelines and the applicable federal statutes.
An indictment is an allegation only. All defendants are presumed innocent and are entitled to a fair trial, at which the government must prove their guilt beyond a reasonable doubt.