Two Individuals and a Corporation Sentenced for Their Roles in Multimillion-Dollar Health Care Fraud and Money Laundering Scheme
WEST PALM BEACH, Fla. -- Smart Lab LLC, and the corporation’s Chief Executive and Chief Operating Officers were sentenced Nov. 1, 2018, for their participation in a multimillion-dollar health care fraud scheme that involved the filing of fraudulent insurance claim forms and defrauding health care benefit programs.
According to a press release from the United States Attorney’s Office, Southern District of Florida, H. Hamilton Wayne, a/k/a “Hawkeye,” 40, of Palm Beach Gardens, Justin Morgan Wayne, 39, of Boca Raton, and Smart Lab LLC, of Palm Beach Gardens, previously pleaded guilty to one count of conspiracy to commit health care fraud. U.S. District Judge Donald M. Middlebrooks sentenced Smart Lab Chief Executive Officer H. Wayne to 63 months in prison, to be followed by 3 years of supervised release; Smart Lab Chief Operating Officer J. Wayne to 46 months in prison, to be followed by 3 years of supervised release; and the corporation to 3 years of probation. The three defendants were jointly and severally ordered to pay $2,897,389.50 in restitution to the victims of their offenses. H. Wayne was separately ordered to pay $954,344 to the TRICARE program for his involvement in fraud at RX to You, along with a $50,000 fine. J. Wayne was separately ordered to pay a $20,000 fine.
The Waynes established relationships in which H. Wayne and co-conspirators would solicit bodily fluid samples from substance abuse treatment centers for confirmatory drug testing at Smart Lab’s facility. According to court documents, the scheme sought insurance payments for the testing -- testing that was medically unnecessary. In exchange for the submission of bodily fluid samples, Smart Lab would kick back a portion of insurance reimbursements for the testing, fraudulently disguised as payments for sales commissions, to the treatment centers. Amtrak’s insurance programs paid more than $114,000 to Smart Lab over the course of the scheme, according to Amtrak Office of Inspector General investigators.
The Amtrak OIG is supporting the FBI-led Greater Palm Beach Health Care Fraud Task Force in its ongoing investigation into a series of complex insurance fraud schemes in Florida. Amtrak OIG investigators were invited to be part of the task force in 2014 after Amtrak insurance providers received allegedly fraudulent charges from substance abuse treatment centers and facilities known as “sober homes” in the area.
United States Attorney’s Office, Southern District of Florida Press Release: https://www.justice.gov/usao-sdfl/pr/two-individuals-and-corporation-se…