CITIZEN STAFF REPORT

PIKEVILLE — A Pikeville businessman will serve 125 months in prison for wire and health care fraud.

Eugene Sisco, III, 36, of Pikeville, was sentenced Tuesday after a jury convicted him in November 2021.

Evidence came out in the trial that Sisco operated several medication-assisted treatment clinics in Pike, Floyd, and Harlan counties that offered treatment to patients suffering from opioid addiction. These clinics were enrolled as providers in the Kentucky Medicaid program, and under Kentucky law, were required to bill that insurance program for MAT services rendered to Medicaid patients.

Sisco deceived patients into paying $200-$300 per month in cash for treatment at his clinics, officials stated, despite having Medicaid insurance, by falsely claiming his clinics were not eligible to bill Medicaid for certain services they provided.

The evidence at trial showed that the cash payments from patients totaled around $5 million between May 2016 and October 2019, most of it from Medicaid beneficiaries for whom the services should have cost nothing.

Sisco caused his clinics to bill Medicaid for MAT services, receiving millions in reimbursements from that program as well, according to court records.

The jury also found that Sisco engaged in a health care fraud scheme by causing his laboratory, Toxperts LLC, to bill for medically unnecessary urine drug testing of samples collected from patients at his clinics.