Jury convicts former NFL player in $328M Medicare fraud scheme: DOJ

DALLAS (TNND) — A federal jury in Texas convicted a former NFL player — and current laboratory owner — for orchestrating a $328 million health care fraud scheme involving “medically unnecessary genetic testing.”

The Department of Justice (DOJ) said 39-year-old Keith J. Gray was found guilty of conspiracy to defraud the U.S. and to pay and receive health care kickbacks, five counts of violating the Anti-Kickback Statute, and three counts of money laundering.

“Gray, the owner and operator of two clinical laboratories, Axis Professional Labs LLC (Axis), and Kingdom Health Laboratory LLC (Kingdom), offered and paid kickbacks to marketers in exchange for their referral of Medicare beneficiaries’ DNA samples, personally identifiable information (including Medicare numbers) and signed test orders from medical providers authorizing the medically unnecessary genetic tests,” the DOJ said on Friday, citing court documents and evidence presented during the trial.

In a news release, prosecutors said Gray paid kickbacks to marketers in exchange for Medicare beneficiaries’ DNA samples and personal information. He also signed physician orders authorizing the testing, according to the release.

The marketers allegedly used telemarketing campaigns to solicit seniors and then engaged in “doctor chasing,” pressuring primary care physicians to approve testing for patients who had been pre-screened by non-medical personnel.

To conceal the illegal payments, Gray allegedly used “sham contracts” and falsified invoices labeled as “marketing” services. But, prosecutors said, the amounts were calculated to match agreed-upon per-sample kickback payments. Evidence presented at trial also showed Gray referred to some payments as “software” fees or loans that did not exist.

Jurors were shown text messages between Gray and a co-conspirator celebrating the profits generated from Medicare reimbursements.

“For example, Gray’s co-conspirator stated, “$ent, you should have it any minute if you don’t already. Get it?” Gray responded, “Sorry I was filling my bathtub with ones. Yes lol,” according to the release.

Authorities said Axis and Kingdom submitted approximately $328 million in fraudulent claims to Medicare, which paid out about $54 million.

“Gray laundered some of the proceeds by purchasing expensive luxury vehicles, including a Dodge Ram truck worth more than $142,000 and a Mercedes Benz SUV worth more than $145,000,” the DOJ noted.

Gray faces a maximum penalty of 10 years in prison on each count. A sentencing date has not yet been set, as a federal judge will determine the final sentence after considering U.S. Sentencing Guidelines and other statutory factors.

Federal officials said the prosecution is part of the DOJ’s ongoing Health Care Fraud Strike Force Program, which has charged more than 6,200 defendants accused of billing federal health programs and private insurers more than $45 billion since 2007.