A Lavaca, Arkansas, man was sentenced to 15 years in prison followed by three years of supervised release and ordered to pay $29,835,825.99 in restitution for conspiracy to commit healthcare fraud and money laundering – via insurance claims for diagnostic lab testing.
Billy Joe Taylor, age 44, pleaded guilty to conspiracy to commit healthcare fraud and money laundering on October 27, 2022. According to court documents, Taylor and his co-conspirators submitted more than $134 million in false and fraudulent claims to Medicare in connection with diagnostic laboratory testing, including urine drug testing and tests for respiratory illnesses during the COVID-19 pandemic, that were medically unnecessary, not ordered by medical providers, and not provided as represented.
Taylor and his co-conspirators obtained medical information and private personal information for Medicare beneficiaries, and then misused that confidential information to repeatedly submit claims to Medicare for diagnostic tests. According to court documents, Taylor and his co-conspirators received more than $38 million from Medicare on those fraudulent claims.
The fraudulent claims were submitted on behalf of five clinical labs during the time they were owned or controlled by Taylor and his co-conspirators.
The FBI, Department of Health and Human Services-Office of Inspector General, and IRS-Criminal Investigation investigated the case involving fraud and testing. First Assistant U.S. Attorney Kenneth Elser of the U.S. Attorney’s Office for the Western District of Arkansas and Senior Litigation Counsel Jim Hayes and Trial Attorney D. Keith Clouser of the Criminal Division’s Fraud Section’s National Rapid Response Strike Force prosecuted the case.
