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Texas hospital CEO pleads guilty to role in multimillion-dollar pass-through payment scheme

March 13, 2019 / Paige Minemyer

The former CEO of a small Texas hospital pleaded guilty to defrauding three of the state’s largest payers out of millions through a laboratory billing scheme. The Department of Justice announced that Harris Brooks, former CEO of Palo Pinto General Hospital in Mineral Wells, Texas, will face a prison sentence of up to five years and restitution payments for his role in the scheme. Brooks and co-conspirators took advantage of the hospital’s in-network deals with Cigna Texas, BlueCross BlueShield of Texas and UnitedHealthcare to use pass-through billing for laboratory services. Brooks and other participants and the scheme submitted billing for allergy and genetic tests they said were performed on-site at PPGH, according to DOJ. However, the hospital did not actually own the equipment for such tests, and patients were provided these services elsewhere.