![]() ![]() Although I noted then that there seemed to be an “uptick in local healthcare and government procurement fraud enforcement” on the criminal side, the USAO has had something of a reputation for pursuing its more complex healthcare fraud cases civilly though the FCA, as opposed to through criminal indictments of individual employees and executives. Last spring, I wrote an update on the Department’s pursuit of individual executives and employees in fraud cases. It is possible that the December 2020 guilty plea from Sanders, with the follow on of this month’s charges against Alshalabi, is a sign that Nashville’s local USAO in particular is becoming more aggressive in its criminal fraud enforcement activities involving individual defendants. It is also noteworthy that neither press release from the Office references a Department of Justice (DOJ or Department) Trial Attorney being involved in the case, indicating that the investigations and prosecutions originated here at the local USAO. The Alshalabi and Sanders cases have similar facts and are being prosecuted by the same Assistant U.S. Just late last year, the Office announced that Vernon Sanders, the owner of FastScripts, LLC, had pled guilty to conspiracy to pay and receive kickbacks related to Medicare genetic testing referrals. ![]() ![]() And this is not the first recent criminal case that the USAO in Nashville has brought relating to genetic testing. The USAO cases referenced in the link above are FCA resolutions involving alleged violations of the AKS.īut Alshalabi is facing up to ten years in prison if convicted. The AKS is a criminal statute, but the government often chooses to enforce it through civil FCA cases because of the ostensibly lower burden of proof and availability of treble damages. What is interesting is that Alshalabi is facing criminal charges. The Middle District of Tennessee itself has a record of pursuing kickback cases against pathology laboratories. After all, the government has a history of pursuing False Claims Act (FCA) cases relating to genetic testing. It is not unexpected that the government is pursuing an enforcement action in a case like this. Over a four-year period, the government paid Crestar almost $14 million on allegedly tainted Medicare claims. Alshalabi paid illegal kickbacks and bribes in exchange for the doctor’s orders and tests, without regard to any medical necessity. Often, the patients or their treating physicians never received the results of the tests. The tests were then approved by telemedicine doctors who did not engage in the treatment of the patients, and often did not even speak with the patients for whom they ordered tests. Marketers, who were not health care professionals, obtained swabs from the mouths of the patients at nursing homes, senior health fairs, and elsewhere. The government alleges that Alshalabi and Crestar paid illegal kickbacks “in exchange for the solicitation of genetic tests from Medicare beneficiaries.” Specifically, AlshalabiĬontracted with marketing companies to target and recruit elderly patients who were federal health care program beneficiaries in order to obtain their genetic material for conducting genetic tests. Attorney’s Office for the Middle District of Tennessee (USAO) announced that it had charged Fadel Alshalabi, the owner and Chief Executive Officer of Spring Hill, Tennessee’s Crestar Labs, LLC (Crestar), with violating the federal Anti-Kickback Statute (AKS) for his role in orchestrating a Medicare fraud scheme relating to genetic testing of cancer patients.
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