By Greg Bailey March 22, 2023
Source: The Gadsden Times
Photo Source: Unsplash,
An Etowah County man pleaded guilty on Tuesday in a multimillion-dollar kickback and health care fraud case, according to a news release from Prim Escalona, the U.S. Attorney for Alabama’s Northern District.
David Lyle Shehi, 42, of Rainbow City entered the plea before Chief U.S. District Judge L. Scott Coogler on charges of conspiracy to pay kickbacks and commit health care fraud.
The maximum penalty for conspiracy to commit health care fraud and receive kickbacks is five years in prison.
According to the plea agreement in the case, the news release reported, Shehi conspired with others to commit health care fraud and receive kickbacks in exchange for his pain management clinic in Rainbow City, Etowah Pain, ordering items that would be billed to Medicare and other health insurers.
Among those services was electro-diagnostic testing provided by QBR, or Diagnostic Referral Community, based in Huntsville.
Shehi in his plea agreement admitted to receiving a per-patient fee for tests ordered by QBR and subsequently reimbursed by insurance. Those payments were disguised as hourly payments for the ordering physician’s time and their staff’s time.
Dr. Eric Beck, 64, of Huntsville was sentenced by Coogler on Wednesday to 15 months in prison. He pleaded guilty last year to health care fraud consipracy for his involvement in the QBR scheme.
And John Alan Robson, 40, of Trussville, was indicted in February in a related case for health care fraud conspiracy, kickback conspiracy, and kickbacks. All those cases were related to several other cases that have produced convictions, according to the news release.
John Hornbuckle, 53, of Huntsville, QBR’s former chief executive officer, pleaded guilty to health care fraud and kickback conspiracy for orchestrating the fraud. He’s been sentenced to 80 months in prison.
James Ewing Ray, 52, of Gadsden, pleaded guilty to health care fraud and kickback conspiracy. As a sales representative, he marketed QBR’s scheme to Shehi and other medical practices and received kickbacks for each test ordered. He’s awaiting sentencing. A jury in March 2022 convicted Dr. Mark Murphy, 66, and his wife Jennifer Murphy, 66, both of Lewisburg, Tennessee, on drug distribution, fraud and kickback charges. They were each sentenced to 20 years in prison.
The Murphys operated North Alabama Pain Services, according to the news release, which closed its Decatur and Madison offices in 2017. According to court documents and evidence presented at trial, they took kickbacks from QBR totaling more than $1 million, in return for Dr. Murphy ordering electro-diagnostic tests from QBR for his patients, regardless of the need. He also pre-signed prescriptions for expensive specialty topical creams, sprays and patches, which patients then received whether they wanted them or not.
The Murphys’ co-defendant, Brian Bowman, 42, of Gadsden, pleaded guilty before their trial to health care fraud conspiracy. He admitted marketing QBR’s electro-diagnostic testing to medical providers and receiving a fee from the company for each test they ordered, netting nearly $1 million.
Bowman also admitted marketed high-reimbursing specialty prescription drugs to the Murphys and other providers, and receiving payments for the prescriptions he generated. He is awaiting sentencing.
The FBI and the Department of Health and Human Services’ Office of Inspector General investigated the case. Assistant U.S. Attorneys J.B. Ward and Don Long prosecuted it.
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