The Fifth Circuit has affirmed the convictions of former Boston Heart Diagnostics executives and sales representatives in a criminal Anti-Kickback Statute case arising from what prosecutors described as a sham management-services organization structure used to funnel payments to physicians in exchange for referrals. The decision in United States v. Theiler leaves intact conspiracy convictions tied to a broader healthcare-billing and referral scheme involving Boston Heart Diagnostics, Inc. and several individual defendants, including Susan Hertzberg, Matthew Theiler, David Kraus, and Thomas Hardaway.

For healthcare enforcement practitioners, the ruling is a notable appellate endorsement of the government’s theory that formally documented business arrangements can still amount to criminal kickback conduct when the substance of the arrangement is referral-driven.