Carlos Himpler, Health Care Fraud, Missouri 2024

St. Louis Man Admits to $3.8 Million Health Care Scam

A former St. Louis County health care company owner has pleaded guilty to submitting more than $3.8 million in fraudulent claims to Medicare, Medicaid and private health care benefit programs, according to a plea agreement filed in U.S. District Court in St. Louis.

Carlos Himpler, 44, now of Baton Rouge, Louisiana, pleaded guilty to a felony conspiracy charge. Himpler, who at the time lived in St. Louis County, described himself as a “business development strategist” and owned or operated a series of health care-related businesses.

Himpler and his co-defendant, Dr. Franco Sicuro, owned businesses including Advanced Geriatric Management LLC (AGM) at 10199 Woodfield Lane in Creve Coeur. In the fall of 2014, Himpler and Dr. Sicuro decided to open an in-house testing lab at AGM. They also decided to open Genotec DX, which they held out as a clinical testing laboratory, and agreed to split profits 50-50.

Their goal was to maximize their profits from the lab testing business. Himpler and Dr. Sicuro sought accreditation for both labs under the Clinical Laboratory Improvement Amendments (CLIA), which set forth quality standards for laboratories that test blood, body fluid, and tissue taken from humans for diagnosis, prevention or treatment of disease.

Himpler admitted in his plea agreement that Medicare, Medicaid and private health care insurers paid $1.4 million in pass-through billing and $2.4 million in split billing. The pair used Genotec’s CLIA number. When health insurers began scrutinizing claims submitted by Genotec and became resistant to paying them, Himpler and Sicuro created Midwest Toxicology Group LLC, but never obtained a CLIA certification or any lab equipment.

“Today’s announcement of an additional guilty plea in this investigation demonstrates that HHS-OIG will continue to hold individuals who exploit federal health care programs accountable,” said Curt L. Muller, Acting Special Agent in Charge with the U.S. Department of Health and Human Services, Office of Inspector General.

Himpler admitted in his plea agreement that both labs employed the same part-time employee who would perform tests using the same machine. They also concealed Dr. Sicuro’s co-ownership of Genotec from Medicare, Medicaid and private health care insurers.

Defendant Information:

Defendant Name: Carlos Himpler

Criminal Charges: Felony Conspiracy Charge

City and State: St. Louis, MO

Exact Date: Not specified

Sentence or Outcome: Pleaded guilty

Dollar Amounts: $3.8 million in fraudulent claims, $1.4 million in pass-through billing, $2.4 million in split billing

Source: https://www.justice.gov/usao-edmo/pr/testing-laboratory-co-owner-admits-38-million-fraudulent-billing