ST. LOUIS — A Chesterfield psychiatrist and his business partner were indicted for their roles in a health care fraud and money laundering scheme.
Dr. Franco Sicuro, of Chesterfield and Carlos Himpler, of Baton Rouge, Louisiana were indicted on multiple charges of conspiracy and health care fraud charges, according to the U.S. Attorney’s Office of Eastern Missouri.
According to a press release, Genotec DX and Midwest Toxicology Group owned by Sicuro and Himpler received more than $15 million dollars for clinical laboratory tests that Genotec DX and Midwest Toxicology Group did not perform.
According to the indictment, the two falsely represented to Medicare, United Health Care, Aetna-Coventry, Anthem Blue Cross-Blue Shield, and Cigna that Genotec DX and Midwest Toxicology Group had performed quantitative urine drug tests and genetic tests, although neither laboratory had the equipment to perform the tests.
They then paid other clinical laboratories about $125 to perform tests on a single urine specimen. Genotec DX and Midwest Toxicology Group then marked-up the same tests and billed insurance companies thousands of dollars for the same tests.
The release also said in many instances, Genotec DX and Midwest Toxicology Group unbundled tests, which should have been billed as one test, billed the tests separately, and were paid $30,000 to $50,000 for a single urine drug test.
They then submitted reimbursement claims on different days for the same patient and date of service but included different billing codes to avoid being detected.
Conspiracy to defraud carries a maximum penalty of five years imprisonment for each count and a fine of $250,000 or both. The health care fraud violations carry a maximum penalty of 10 years imprisonment for each count and a fine of $250,000 or both. Restitution to the victims is also mandatory.
