A Western Kentucky man has admitted that he took part in a scheme with a drug-testing laboratory in Nicholasville to defraud health insurance programs of more than $1.3 million.
Dinesh Goyal, 60, pleaded guilty Monday in federal court to a charge of conspiracy.
Goyal owned a business in Owensboro called Tristate Medical Laboratory.
He admitted that in 2016 he allowed a lab in Nicholasville called C.A.L. Laboratory Services to submit bills for urine drug tests to Medicaid providers under the billing number assigned to Goyal’s lab.
The Medicaid providers had placed restrictions on billing by C.A.L Laboratory Services because of concerns about whether its claims were legitimate, according to U.S. Attorney Robert M. Duncan Jr.
The conspiracy allowed the Nicholasville lab to get payments it wouldn’t have received without the false billing, Duncan said in a news release.
The fraudulent claims caused losses to Humana Caresource, Aetna Coventry Cares, and Anthem Blue Cross & Blue Shield Medicaid totaling $1,378,449, according to Goyal’s plea agreement.
Goyal received 40 percent of the payments from the insurance companies for letting the Nicholasville lab run bills through his business, according to a court document.
Samuel L. Ford, half-owner of a company that did medical billing for the Nicholasville lab, pleaded guilty in March to a conspiracy charge.
The owner of the Nicholasville lab, Mason Routt, died in 2017.
Ford is scheduled to be sentenced in August. U.S. District Judge Joseph M. Hood scheduled sentencing for Goyal in October.
They each face up to five years each in prison.
Goyal also agreed to a civil settlement with the government based on the misconduct. In addition to selling personal and commercial property to make a payment to the government, he won’t be eligible to own or work for a company that bills Medicare or Medicaid for 10 years, according to Duncan’s office.