Two doctors and a nurse practitioner from South Texas are among ten people who have been indicted in a $300 million healthcare fraud, according to an announcement made by the U.S. Attorney’s Office for the Northern District of Texas.
In a 26-count indictment filed on February 9, the defendants — which include Dr. Eduardo Carlos Canova and Dr. Jose Roel Maldonado of Laredo and N.P. Keith Allen Wichinski of San Antonio — were charged with conspiracy to pay and receive healthcare kickbacks, conspiracy to commit healthcare fraud, soliciting or receiving illegal kickbacks, and offering or paying illegal kickbacks.
According to the indictment, the founders of several lab companies allegedly paid illegal kickbacks to induce medical professionals to recommend medically unnecessary lab tests. The tests were then billed to Medicare and other federal healthcare programs.
Family medicine practitioner Jose Maldonado, internal medicine specialist Eduardo Canova, and nurse practitioner Keith Wichinski are accused of accepting the illegal kickbacks and recommending millions of dollars worth of medically unnecessary lab tests.
The lab companies — Reliable Labs LLC, Unified Laboratory Services, and Spectrum Diagnostic Laboratory — disguised the payments as legitimate transactions in the form of salary offsets, lease payments, medical advisor agreement payments, and marketing commissions.
The labs allegedly paid hundreds of thousands of dollars for “advisory services,” which the doctors never performed, in return for the test referrals. The labs are also accused of paying portions of the medical staff’s salaries and a part of their office leases. The payments were contingent on the number of lab tests the doctors referred to the lab.
The founder of Spectrum and Unified, Jeffrey Madison of DeSoto, reportedly convinced Biby Kurian and Abraham Phillips, co-founders of Reliable, to convert their lab into a physician-owned lab so they could disguise more kickbacks using a provider-ownership model.
Defendants in the alleged scheme are:
- Mark Christopher Boggess, chief operating officer for Spectrum and Unified
- Jeffrey Paul Madison, founder of Unified Laboratory Services and Spectrum Diagnostic Laboratory
- Dr. Eduardo Carlos Canova, internal medicine specialist based in Laredo
- Abraham Phillips, co-founder of Reliable Labs, LLC
- Biby Ancy Kurian, co-founder of Reliable Labs, LLC
- David Michael Lizcano, owner of DCLH, a marketing firm engaged by Unified, Spectrum, and Reliable
- Juan David Rojas, owner of Rojas & Associates, another marketing firm engaged by Unified, Spectrum, and Reliable
- Laura Ortiz, sister of David Lizcano and employee at his marketing firm
- Dr. Jose Roel Maldonado, family medicine doctor, based in Laredo
- Keith Allen Wichinski, board-certified nurse practitioner based in San Antonio.
The defendants face up to 55 years in federal prison if convicted of the crime.
