In a not all that surprising outcome, given the cast of characters involved, a former NFL player involved in a genetic testing company that ended up just defrauding Medicare out of millions of dollars has been convicted of the fraud scheme on multiple counts by a federal jury. Such is what the DOJ announced in a press release promulgated on February 20.
For reference, the player involved is Keith Gray. Gray is 39 years old, and played for the University of Connecticut as a football player before heading to the NFL, where he briefly played for the Carolina Panthers. After leaving the NFL, he became involved with cardiovascular genetic testing, and owned two clinical labs involved in such testing. He has been caught in major fraud involving those labs.
Beginning its press release on the conviction of Mr. Gray and what his scheme entailed, the DOJ began by summarizing what had happened, saying, “A federal jury in Dallas convicted a Texas laboratory owner and former NFL player yesterday for his role in a $328 million cardiovascular genetic testing fraud scheme.”
Continuing, the DOJ set about explaining what his scheme entailed. It began that section by providing, “According to court documents and evidence presented at trial, Keith J. Gray, 39, of McKinney, Texas, orchestrated a scheme to bill Medicare for medically unnecessary genetic tests designed to evaluate the risk of various cardiovascular diseases and conditions.”
Adding to that, the DOJ said, “Gray, the owner and operator of two clinical laboratories, Axis Professional Labs LLC (Axis), and Kingdom Health Laboratory LLC (Kingdom), offered and paid kickbacks to marketers in exchange for their referral of Medicare beneficiaries’ DNA samples, personally identifiable information (including Medicare numbers) and signed test orders from medical providers authorizing the medically unnecessary genetic tests.”
Further exposing the details of the huge scheme, the statement noted, “As part of the scheme, the marketers engaged other companies to solicit Medicare beneficiaries through telemarketing and to engage in “doctor chase,” i.e., to obtain the identity of beneficiaries’ primary care physicians and pressure them into approving genetic testing orders for patients who purportedly had already been “qualified” for the testing during telephone calls conducted by non-medical personnel at one of the companies retained by the marketers — not by their physicians.”
Then, turning to how he tried to conceal the massive fraud scheme, it provided, “In an effort to conceal the kickback payments, Gray used sham contracts and invoices that purported to charge for “marketing” hours but that in reality were reverse-engineered to match the amounts agreed to under the illegal per-sample kickback arrangement. Gray also sought to conceal the scheme by, among other things, referring to the payments as being for “software” and loans that never existed.”
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Giving an example of Gray admitting to defrauding Medicare and being ecstatic over the amount of money pilfered, the statement then said, “Evidence at trial included text messages between Gray and his co-conspirator becoming giddy over the amount of money they were making from Medicare. For example, Gray’s co-conspirator stated, ‘$ent, you should have it any minute if you don’t already. Get it?’ Gray responded, ‘Sorry I was filling my bathtub with ones. Yes lol.’”
And, noting the massive nature of the scheme, the DOJ noted, “Axis and Kingdom billed Medicare approximately $328 million for the false, fraudulent and kickback-tainted genetic testing claims, of which Medicare paid approximately $54 million. Gray laundered some of the proceeds by purchasing expensive luxury vehicles, including a Dodge Ram truck worth more than $142,000 and a Mercedes Benz SUV worth more than $145,000.”
Gray has been convicted: “The jury convicted Gray of conspiracy to defraud the United States and to pay and receive health care kickbacks, five counts of violating the Anti-Kickback Statute and three counts of money laundering. He is scheduled to be sentenced at a later date. Gray faces a maximum penalty of 10 years in prison on each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.”
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Featured image credit: NFL Photos