United States Obtains $30.5 Million Fraud Judgment Against Texas-Based Lab Services Company and CEO
HOUSTON – A federal judge has ruled that BestCare Laboratory Services LLC and its founder and CEO Karim Maghareh defrauded Medicare by billing for thousands of miles that were not actually travelled, announced U.S. Attorney Ryan Patrick.
U.S. District Judge Lynn Hughes of the Southern District of Texas awarded the United States $30,571.635 in damages from the Webster, Texas - based company. BestCare serves nursing homes throughout Texas, including San Antonio, Dallas, Austin, Waco and El Paso.
Dr. Richard Drummond discovered the fraud after hiring a former BestCare employee and learning of their billing practices. Drummond filed suit under the False Claims Act which allows private citizens who know of fraud to file suit on behalf of the United States.
As detailed in that lawsuit, Medicare compensates laboratories which serve nursing home patients approximately a dollar per mile for technician travel. The travel must be for the purpose of collecting a specimen from a home-bound or nursing home-bound patient, not for the purpose of picking up and transporting specimens already collected. The miles are supposed to be pro-rated among the number of patients from whom they are collected.
The court found that BestCare not only failed to prorate miles, but shipped batches of specimens by air freight to Houston at a cost of approximately $100 per batch then billed Medicare for the round-trip distance between the nursing home and the lab in Webster.
The court found BestCare billed Medicare for $10.1 million in claims for miles which no lab tech traveled. The False Claims Act mandates trebling of the damages, resulting in a judgment of $30.5 million.
The FBI, U.S. Department of Health and Human Services – Office of Inspector General investigated the case along with the U.S. Attorney’s Office and Civil Division of the U.S. Department of Justice. Assistant U.S. Attorneys Michelle Zingaro and Daniel David Hu and Trial Attorney Richard Nicholson handled the matter.