Former Owner of Wilksboro Clincial Laboratory Pleads Guilty to Criminal Health Care Fraud and Tax Fraud Charges and Agrees to Pay $300,000 to Settle Civil Fraud Allegations
|U. S. Attorney’s Office April 25, 2013|
CHARLOTTE, NC—The former owner of Wilkesboro Clinical Laboratory (WCL) pleaded guilty today in U.S. District Court for his involvement in a health care fraud scheme in which he and his company billed Medicare for services which were not rendered, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Louis Francis Curte, 49, also admitted he filed false tax returns from 2007 to 2010.
In a separate civil settlement with the U.S. Attorney’s Office, Curte also agreed to pay $300,000 to resolve civil fraud allegations that he and his company violated the Physician Self-Referral Act or “Stark Law.”
U.S. Attorney Tompkins is joined in making today’s announcement by Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Office of Investigations, Atlanta Region; Jeannine A. Hammett, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation Division (IRS-CI); and John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division.
Curte appeared before U.S. Magistrate Judge David C. Keesler today and pleaded guilty to four counts of health care fraud and one count of filing a false tax return. According to court documents and today’s plea hearing, Curte was the owner and operator of WCL, which was enrolled with the Medicare program and provided microbiology and other laboratory services. Court records show that from at least 2007 to in or about 2009, Curte defrauded Medicare by submitting false and fraudulent claims for microbiology services that were never rendered.
Court documents indicate that Curte and WCL used another company (“Company #1”) for certain types of microbiology testing that could not be performed by WCL in-house. Court records show that WCL generally submitted specimens to Company #1 to test for the presence of infection-causing bacteria. If an infection was present in a specimen, Company #1 then typically performed one or two additional tests to identify the type of pathogen present (“identification test”) and the type of antibiotic to which the pathogen was susceptible (“susceptibility test”). Pursuant to the scheme to defraud, Curte routinely billed Medicare for identification and susceptibility tests, when, in fact, no such tests were performed and even when the initial testing indicated that no pathogen was actually present in the specimen. According to the plea agreement, the intended loss to Medicare by the defendant was between $10,000 and $30,000.
At today’s hearing, Curte also pleaded guilty to filing false tax returns for the years 2007 through 2010. According to filed documents and court proceedings, Curte filed false tax returns which substantially understated his gross income, and therefore, the tax owed to the United States. Court records indicate that Curte maintained false books in an attempt to mask a prohibited business relationship with a physician, identified in court documents as Dr. T.M. According to the plea agreement, the amount of tax loss was more than $30,000 but less than $50,000.
At sentencing, Curte faces a maximum term of 10 years in prison and a $250,000 fine for the health care fraud charges and a maximum term of three years in prison and a $250,000 fine for the tax fraud charge. In his plea agreement, Curte agreed to pay full restitution to Medicare and to IRS for any losses. The final restitution amount will be determined by the court at Curte’s sentencing hearing, which has not been scheduled yet. Curte has been released on bond pending sentencing.
Curte’s prohibited relationship with Dr. T. M. forms the basis for Curte’s civil settlement agreement. According to the civil settlement agreement, from January 1, 2006 through April 30, 2009, Curte and WCL violated the Stark Law by knowingly having a prohibited financial relationship with Dr. T.M.
Dr. T.M. owned and operated a billing company, now defunct, which submitted all of WCL’s reimbursement claims to Medicare. Dr. T.M.’s billing company was paid on a “per claim” basis for the reimbursement claims submitted to Medicare on behalf of WCL. As an owner of the billing company, Dr. T.M. benefitted directly from WCL’s payments to his billing company. Investigators also found that Dr. T.M. referred blood and tissue specimens to WCL for pathology testing.
The Stark Law forbids a medical provider from billing Medicare and Medicaid for certain services referred by physicians who have a financial relationship with the medical provider. A prohibited financial relationship includes an agreement between the medical provider and a physician to compensate the physician based on the volume of the physician’s referrals or the revenue realized through those referrals.
Under the terms of the settlement agreement, Curte is required to reimburse the government for the amount he wrongfully received from Medicare in violation of the Stark Law and to pay penalties back to the program, for a total of $300,000.
The investigation into Curte was handled by HHS-OIG and IRS, with the assistance of the FBI. The criminal prosecution was handled by Assistant U.S. Attorney Kelli Ferry.
Assistant U.S. Attorney Don Caldwell handled the civil settlement.
The investigation and charges are the work of the Western District’s joint Health Care Fraud Task Force. The task force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system and reducing the potential for health care fraud in the future. The task force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing of all whistle blower complaints, and the creation of investigative teams so that individual agencies may focus their unique areas of expertise on investigations. The task force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 (1-800-HHS-TIPS) or e-mail at HHSTips@oig.hhs.gov. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.