Baton Rouge Laboratory Owner and Florida Woman Charged with Scheme to Pay and Receive Health Care Kickbacks as Part of National Enforcement Action
Published 12:55 pm Sunday, September 19, 2021
The Medicare Fraud Strike Force (“MFSF”) is part of a joint initiative between the U.S. Department of Justice, U.S. Department of Health and Human Services and state Medicaid Fraud Control Units to reduce and prevent Medicare and Medicaid fraud through enhanced interagency cooperation. Its purpose is to focus on the worse offenders in fraud, in the highest intensity regions, using data analysis techniques to identify abnormal billing levels in health care fraud “hot spots,” i.e., cities with unusually high levels of billing and other fraud. The U.S. Department of Justice currently maintains 15 strike forces operations in 24 federal districts and has charged more than 4,600 defendants who have collectively billed federal health care programs and private insurers for approximately $23 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
As part of the recent National Enforcement Action, Acting United States Attorney Ellison C. Travis announced new charges against two individuals for health care related crimes in Baton Rouge. On September 9, 2021, a federal grand jury returned a seven-count indictment charging Terry Steven Wilks, Jr., age 39, of Greenwell Springs, Louisiana, and Leslie Amanda McHugh, age 36, of Riverview, Florida, with conspiracy to defraud the United States and to pay and receive kickbacks, offering and paying kickbacks, and soliciting and receiving kickbacks.
According to the indictment, Wilks was the owner of Acadian Diagnostic Laboratories, LLC, a clinical laboratory based in Baton Rouge that provided diagnostic testing services, including urine drug testing. Acadian was enrolled as a Medicare and a TRICARE provider. McHugh was formerly a registered nurse licensed in the State of Florida. The indictment alleges that in 2015, the Florida Board of Nursing revoked McHugh’s nursing license, and in 2016, Medicare excluded her from participation in all federal health care programs. According to the indictment, despite her exclusion and subsequent purported termination from Acadian, Wilks continued to pay McHugh to refer doctors’ orders and specimens to Acadian for urine drug testing in exchange for kickback payments. These payments were allegedly made in cash, as well as funneled through a company created by Wilks. The indictment alleges that from August 2017 to April 2018, Wilks and McHugh caused Acadian to submit approximately $549,580 in claims to Medicare and $17,612 in claims to TRICARE for laboratory testing services that were referred by McHugh in exchange for kickback payments.
Acting U.S. Attorney Ellison Travis stated, “My office will continue to work tirelessly with our outstanding federal, state and local partners to identify and bring justice to those who commit healthcare related crimes. This takedown was a team effort, and I commend the excellent work performed by our prosecutors and the men and women of the agencies involved.”
“Today’s indictment sends a clear message to individuals like Terry Wilks and Leslie McHugh who engage in kickback schemes which defraud health care programs that they will be held accountable. Mr. Wilks and Ms. McHugh took advantage of a system set up to help patients get much-needed government assistance and instead benefitted themselves,” said FBI New Orleans Special Agent in Charge Douglas A. Williams, Jr. “We would like to thank our state and federal partners with the Medicare Fraud Strike Force for their strong partnership and unrelenting pursuit of justice.”
Miranda L. Bennett, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General, Dallas Region, stated: “Today’s indictment is yet another example of our commitment to vigorously defend the Medicare Trust Fund. Paying and receiving kickbacks for referrals undermines federal health care programs. We will continue to pursue those who conduct fraudulent kickback schemes to safeguard the beneficiaries of these programs.”
“I applaud my Medicaid Fraud Control Unit and our partners at the U.S. Attorney’s Office for their efforts to end criminal activity, especially when it is being perpetuated by people who are supposed to be taking care of our State’s vulnerable,” said Attorney General Jeff Landry.
This matter is being investigated by HHS-OIG, the FBI, and the Defense Criminal Investigative Service and was brought as part of the MFSF, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District of Louisiana. The case is being prosecuted by Assistant United States Attorney Kristen L. Craig and Department of Justice Trial Attorney Justin M. Woodard.
NOTE: An indictment is an accusation by a grand jury. The defendant is presumed innocent until and unless adjudicated guilty at trial or through a guilty plea.