Raleigh Man Pleads Guilty to Receiving More than $60 Million in Fraudulent Claims from Paying Kickbacks for Patient Referrals

WILMINGTON, N.C. - A Raleigh man, James Shuford Price, III, 59, pleaded guilty in federal court to the crime of paying illegal kickbacks for referrals to his California-based lab and filing a false federal tax return. At sentencing, Price faces a statutory maximum of 13 years' imprisonment, a $500,000 fine, and three years of supervised release. Price will also be required to pay restitution to the California Medical Assistance Program (Medi-Cal), the Centers for Medicare & Medicaid Services, the Internal Revenue Service (IRS), and others.

"Stealing taxpayer dollars that should be used to help legitimate beneficiaries is lowdown, dirty pool. We have a message to fraudsters who steal federal dollars: we will catch, prosecute, and imprison you. Cheaters. Never. Win." said U.S. Attorney Ellis Boyle.

"This guilty plea demonstrates the FBI's unwavering commitment to protecting federal healthcare programs and the taxpayers who fund them. Orchestrating a $60 million Medicare fraud scheme is a profound violation of public trust. This guilty plea is the direct result of meticulous investigative work conducted alongside our law enforcement and government partners," said Reid Davis, the FBI Special Agent in Charge in North Carolina.

"Today's plea reflects our commitment to protecting patients, clinicians, and taxpayer funded programs from those who try to profit through deception," said Special Agent in Charge Donald "Trey" Eakins, Charlotte Field Office, IRS Criminal Investigation. "The defendant orchestrated an extensive fraud scheme generating thousands of illegitimate laboratory test claims to Medi Cal and Medicare resulting in multimillion-dollar reimbursements. This scheme not only violated federal healthcare programs but undermined trust in critical medical services."

"Effectively investigating complex fraud schemes like this one requires close coordination among federal and state agencies from coast to coast. This favorable outcome shows that HHS-OIG and its partners will aggressively pursue fraudsters who try to illegally boost profits using kickbacks, which compromise impartial medical decision-making and drive up health care costs for everyone," said Special Agent in Charge Robb R. Breeden of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Pacific Region. "This case shows how teams of dedicated investigators and prosecutors working together across jurisdictions can make a powerful impact in protecting Medicare and Medicaid and the millions of Americans served by these programs. HHS-OIG will continue to collaborate closely with our partners to safeguard patients and defend federal health care programs from fraud."

"California is committed to protecting the integrity of our health care programs and ensuring taxpayer dollars are used appropriately," said Department of Health Care Services Director Michelle Baass. "We appreciate our partnership with our colleagues at the U.S. Department of Justice in pursuing this case. Together, we are strengthening oversight, holding bad actors accountable, and safeguarding the Medi-Cal program so it can continue delivering vital services to the Californians who rely on it every day."

According to court documents and other information presented in court, Price owned and operated Golden Star Labs (GSL), a laboratory facility in Los Angeles, California. Between August 2023 and June 2025, GSL submitted more than $85 million in false claims to Medi-Cal and more than $11 million in false claims to Medicare for multi-panel testing for SARS-CoV-2 (COVID-19), Influenza A and B (the flu), and Respiratory Synctial Virus (RSV). The fake claims came from fraudulent test samples and resulted in Medi-Cal and Medicare's disbursing of more than $60 million to GSL.

As part of the scheme, GSL engaged so-called "collectors" in California and elsewhere to source test specimens from Medi-Cal/Medicare beneficiaries. Under Price's direction and control, GSL unlawfully induced the collectors to supply samples by compensating them, in whole or in part, based on the volume of samples provided to the lab. Between August 2023 and January 2025, GSL paid over $17 million to these collectors. In exchange, the collectors supplied GSL with bulk quantities of bogus test samples obtained under fraudulent circumstances, including widespread identity theft. GSL then systematically billed Medi-Cal and Medicare for testing the sham samples.

For example, in the first six months, approximately 96% of GSL's Medi-Cal claims were fraudulent test authorizations from a single out-of-state physician whose personal identifiers were stolen and misapplied. In February 2024, Price purported to pause GSL's testing operations for a month to "clean up" the billing issues. However, GSL went right back to it, basing its claims on fraudulent specimens provided by collectors after the lab resumed operations and billing in March 2024. From late March 2024 until January 2025, approximately 92% of GSL's Medi-Cal claims were premised on phony test authorizations generated from the stolen personal information of five different clinicians.

During this same period, Price directed GSL to enter written contracts with collectors specifying a fixed fee for services and prohibiting payments based on the volume or value of referrals. These fake contracts were meant to give the false appearance that GSL was complying with the law. However, the same kickback scheme with GSL paying collectors on a per-specimen basis to induce referrals continued without regard to these phony contracts, resulting in millions of dollars in Medi-Cal/Medicare payouts to GSL.

During the investigation, the FBI worked with the U.S. Attorney's Office to seize more than six million dollars in assets attributable to the fraud.

Price also pleaded guilty to filing a false federal income tax return for the 2022 calendar year. According to the investigation, Price failed to report income from multiple sources, including money received from victims in connection with a prior investment scam.

Medi-Cal is a state-administered Medicaid program funded jointly by California and the U.S. government. The law only provides for Medi-Cal and Medicare to pay private clinical labs like GSL for diagnostic testing services when an authorized treatment provider ordered such medically necessary services.

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division ("Fraud Division"). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department's work to combat fraud supports President Trump's Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.

Ellis Boyle, U.S. Attorney for the Eastern District of North Carolina, made the announcement. The FBI (Charlotte Field Office, Raleigh Resident Agency) investigated this case in partnership with IRS-CI (Charlotte Field Office), the U.S. HHS-OIG (Pacific Regional Office), and the California Department of Health Care Services, Investigations Division.

More information about the Healthcare Fraud Takedown can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.

A copy of this press release is located on our website. Related court documents and information can be found on the website of the U.S. District Court for the Eastern District of North CarolinaLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. or on PACERLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. by searching for Case No. 5:26-CR-00087-M-1.