Owensboro man pleads guilty to health care fraud conspiracy

LEXINGTON, Ky. (WTVQ) – Prosecutors say an Owensboro man has admitted he participated in a conspiracy to defraud health insurance programs of more than $1.3 million.

Dinesh Goyal owned a toxicology laboratory in Owensboro called Tristate Medical Laboratory.

The U.S. Attorneys Office for the Eastern District of Kentucky says Goyal and two other men, Mason Routt and Sam Ford, had urine drug tests performed by C.A.L. Laboratory Services in Nicholasville, but would bill the health insurance programs using Tristate’s billing information, falsely representing that the tests were performed by Tristate.

According to prosecutors, using Tristate’s billing information helped CAL evade the payment restrictions placed upon it by the insurers, and receive reimbursements it wasn’t entitled.

Prosecutors say, in exchange for the use of his lab’s billing information, Goyal received 40% of the fraudulent reimbursements.

Humana Caresource, Aetna Coventry Cares, and Anthem Blue Cross & Blue Shield Medicaid lost $1,378,449 as a result of the fraud, according to prosecutors.

Goyal is scheduled to be sentenced on October 15, 2019.

He faces up to 5 years in prison and a maximum fine of $250,000.

Ford pled guilty in March 2019 and is scheduled to be sentenced next month.

Mason Routt, the owner of CAL, passed away unexpectedly in August 2017.