Kentucky Doctor Pleads Guilty in Johnstown to Conspiring to Defraud the U.S.
JOHNSTOWN, Pa. - A resident of Louisville, Kentucky, pleaded guilty in federal court to a charge of conspiring to commit an offense against the United States, United States Attorney Scott W. Brady announced today.
Dr. John R. Baird, 52, pleaded guilty to one count before United States District Judge Kim R. Gibson.
In connection with Dr. Baird’s guilty plea to conspiring to commit an offense against the United States:
Universal Oral Fluid Labs ("UOFL") was a clinical drug testing and drug screening laboratory located in Greensburg, Pennsylvania. UOFL was located at 475 Willow Crossing Road, Greensburg, Westmoreland County, Pennsylvania. Dr. Baird was a physician licensed in the Commonwealth of Kentucky and the State of Indiana, who specialized in physical medicine, rehabilitation and pain treatment. Dr. Baird’s primary medical practice was located at 3012 East Point Parkway, Louisville, Kentucky 40223.
Both Dr. Baird and UOFL were enrolled providers in the Medicare program and the Kentucky Medicaid program. As a condition of becoming a Medicare provider and being authorized to bill Medicare, Dr. Baird and UOFL, like all other providers of health services to Medicare patients, were required to certify on their enrollment applications that they would comply with all applicable federal and state laws, regulations, policies, procedures, and program requirements.
UOFL billed, and was paid by, Medicare for performing drug tests and related services for Medicare beneficiaries who were referred to UOFL by physicians enrolled in the program, including Dr. Baird.
From on or about May 1, 2012, and continuing thereafter until at least July 31, 2013, in the Western District of Pennsylvania and elsewhere, Dr. Baird conspired with persons at UOFL and others to commit offenses against the United States, that is, to solicit and receive kickbacks from UOFL in return for referring patients to UOFL for the referral of patient lab
work, for which payment was made in whole or in part under a Federal health care program, namely, Medicare and Medicaid, contrary to Title 42, United States Code, Section 1320a- 7b(b)(1)(A).
It was a part of the conspiracy that Dr. Baird received monthly checks from UOFL in exchange for referrals, including Medicare and Medicaid referrals. Specifically, the monthly kickback checks UOFL paid to Dr. Baird were paid pursuant to the terms of a "joint venture" that Dr. Baird entered into with UOFL. Under this "joint venture," Dr. Baird referred all of his patients, including Medicare and Medicaid beneficiaries, to UOFL for drug testing and related services. UOFL, in turn, billed third-party payors, including Medicare and Medicaid, for such tests, and then kicked back to Dr. Baird, for each referred patient, reimbursement amounts for the tests that exceeded agreed upon thresholds, which were typically between $100.00 and $150.00. Dr. Baird received these "joint venture" payments from UOFL solely in exchange for the referrals Dr. Baird provided to UOFL, and not in exchange for the performance of any other services. Between May 1, 2012 and July 31, 2013, Dr. Baird received $567,609.36 in kickbacks from UOFL in return for Dr. Baird referring his patients' lab work to UOFL.
Judge Gibson scheduled sentencing for Dec. 6, 2018, at 10:30 a.m. The law provides for a maximum total sentence of 5 years in prison, a fine of $250,000, or both. Under the Federal Sentencing Guidelines, the actual sentence imposed would be based upon the seriousness of the offense and the prior criminal history, if any, of the defendant.
Assistant United States Attorney Stephanie L. Haines is prosecuting this case on behalf of the government.
The Federal Bureau of Investigation, Health and Human Services Office of Inspector General, the Internal Revenue Service Criminal Investigation, and Pennsylvania Office of Attorney General Medicaid Fraud Control Section conducted the investigation that led to the prosecution of Dr. Baird.