From around 2013 to 2016, outgoing House Speaker Mac McCutcheon (R-Monrovia) worked as a "consultant" for an Alabama-based medical testing company called QBR LLC, which has recently been a target of the U.S. Department of Justice.

John Hornbuckle, the president and CEO of QBR LLC, of Huntsville, was indicted by a federal grand jury for defrauding health care benefit programs and paying and receiving kickbacks from December 2012 to January 2018, according to an indictment filed in U.S. District Court in the Northern District of Alabama in April 2022. 

After initially pleading not guilty, Hornbuckle pleaded guilty to one count of conspiracy to commit health care fraud and one count of conspiracy to receive kickbacks in November. QBR was in the business of conducting electro-diagnostic testing, including nerve conduction velocity tests (NCV tests) and sensory evoked potential tests (SEP tests), according to court records.

Numerous others associated with the company have been either convicted or pleaded guilty to healthcare-related charges in 2022. All of them are currently awaiting sentencing.

McCutcheon and his son, Christopher McCutcheon, and their various roles in this company have eluded public scrutiny, given the Department of Justice press statements have focused on indictments and guilty pleas.

According to financial documents obtained by 1819 News, Mac McCutcheon and his Practical Approach Consulting Group were paid at least $90,000 by QBR LLC in 2013, the latter half of 2015, and the first half of 2016.

A draft organizational chart from 2012, around the time the company got started, described Mac McCutcheon's role at QBR as "government liaison, business and public relations." Other documents described his role as a "customer relationship manager."

According to Alabama Secretary of State records, Practical Approach Consulting was incorporated in December 2014. Christopher McCutcheon, Mac's son and a former 49% owner of QBR, is listed as the initial registered agent. Mac McCutcheon is listed as the president, secretary and treasurer.

The payments to McCutcheon and his consulting group ranged from a rate of $2,500 to $5,000 per month, according to the documents.

Mac McCutcheon was first elected to the House in 2006. Before becoming speaker, McCutcheon served as the House Rules Committee chair. He has served as Alabama's House Speaker since 2016, assuming the role after his predecessor, former House Speaker Mike Hubbard (R-Auburn), was removed from office for felony ethics convictions. McCutcheon did not seek re-election in 2022.

"I have been going back in my records to get the information/dates you are inquiring about," Mac McCutcheon told 1819 News in an emailed response to questions about his involvement in the company. "My association with QBR was based on helping the company get started. I was contracted to do consultant work for the business start-up. I was retiring from the City of Huntsville in 2013 and began my consulting business as a source of income due to the fact that the Legislative work is part-time. I never did any lobbying work for QBR or any other client. As QBR got operational as a company I discontinued my services. "

QBR LLC was formed in September 2011 by Hornbuckle and Christopher McCutcheon, according to the Alabama Secretary of State's Office.

The McCutcheons haven't been charged or accused of any wrongdoing by federal authorities, but their clout and influence were used to help with regulatory and legal hurdles the company faced at the state level, according to emails obtained by 1819 News.

Chris McCutcheon emailed Mac McCutcheon and Hornbuckle in January 2012, letting Mac know that "we, as QBR representatives, are presenting this services agreement to you for review and stated opinion from the State Attorney General's office."  

"We would like to receive the assessment from the AG's office in order to ensure that we [are] operating within the specified guidelines of the medical industry as well as the State of Alabama," Chris told Mac in the email. "Please pass this agreement to state personnel and advise when completed so that we can move forward with the current agreement or make the required changes to do so."

The services agreement outlines a process whereby providers are paid $200 per hour that "shall not vary based on the volume or value of referrals." 

According to the indictment of Hornbuckle, the hourly payments for the provider's time and the time of the provider's staff were "disguised," and the "provider was actually compensated on a per-patient basis."

Chris McCutcheon wrote to Mac McCutcheon two months later in March to ask for a meeting for a business partner with a Blue Cross Blue Shield of Alabama high-ranking official.

"Thank you for spending time with us last week, giving us the tour and assisting us with the meeting with [the] Medical License Director," Chris McCutcheon said in an email to Mac McCutcheon and John Hornbuckle in March 2012. "We would like to request a meeting for Brian Bowman, our business partner in Birmingham, with Robyn at BCBS. You and John [Hornbuckle] should remain in the driver's seat from a meeting coordination and attendance perspective if possible. We, as QBR, want to remain in the power position in regards to meetings that you help us setup because it helps us in the future from a political perspective. Brian has the following agenda in mind with regards to the meeting with Robyn/BCBS: He would like to become a preferred provider for BCBS of Alabama within the Lab [Bloodwork/Urine Panels] space."

Brian Bowman of Attalla, an entrepreneur who marketed QBR's electro-diagnostic testing to medical providers through Compass Labs, which he part-owned, pleaded guilty to one count of healthcare fraud conspiracy in December 2021 after initially pleading not guilty to multiple counts in 2020, according to U.S. District Court Northern District of Alabama Court records and a Department of Justice press release.

The person referred to as "Robyn" in the email is apparently Robin Stone, former vice president of government affairs at Blue Cross Blue Shield of Alabama.

Stone contacted Hornbuckle nearly three years later in January 2015 via email.

"Mac McCutcheon asked me to contact you," Stone said in the email. "We are looking [into] requirements for the Arkansas plan for in-network lab status. I've got a few questions …"

Hornbuckle emailed Chris and Mac McCutcheon again in February 2015 to say, "please let me know if we can help create transparency between physicians and BCBS" over concerns about how a proposed Blue Cross Blue Shield policy dealing with urine drug testing in pain management going into effect the following month would hurt Bowman's Compass Labs.

"Per Compass [Labs], we have a lot of upset physicians on our hands in Alabama that feel like this is going to affect their ability to prescribe medications," Hornbuckle said in the email. "These physicians use the urine drug screen as a tool to pre screen patients to ensure compliance. With the limited ability to test, many physicians feel that patients will become more comfortable and more likely to abuse not only prescription drugs, but illicit drugs as well. Our state is already in the top 5 states for prescription drug abuse and it may continue to rise if this draft is implemented. Please let me know if we can help create transparency between the physicians and BCBS. I really enjoyed the inauguration and seeing you sir."

Mac McCutcheon replied to Hornbuckle, saying, "I will contact BCBS to get more info." 

"We should be pro-active on this," Mac McCutcheon said in the email. "How is that relationship with Compass going?"

The last payment 1819 News could verify from QBR LLC to Practical Approach Consulting was for $1,250 on July 15, 2016.

The business relationship between Hornbuckle and Chris McCutcheon apparently started to sour in 2016, according to court documents.

Christopher McCutcheon filed a civil complaint against Hornbuckle in August 2016 in Madison County Circuit Court requesting compensatory and punitive damages for, in part, Hornbuckle allegedly "taking action as a majority owner to remove [Christopher] McCutcheon as the treasurer, CFO and secretary."

"Additionally, counsel for Hornbuckle sent letters to outside entities such as Bryant Bank informing it that [Christopher] McCutcheon was no longer able to conduct any business on behalf of QBR," G. Bartley Loftin III, Christopher McCutcheon's attorney, wrote in the complaint. "These actions were all in an attempt to exclude [Christopher] McCutcheon from any involvement in the business."

Loftin also wrote in the complaint that "the result is that [Christopher] McCutcheon has been totally squeezed out of the operations of QBR despite the fact that he was the initial investor and is still 49% owner of QBR."

W. Patton Hahn and Julie Schiff, Hornbuckle's attorneys, responded with a counterclaim requesting compensatory and punitive damages from Christopher McCutcheon in September 2016.

"[W]hile working with QBR's outside accountants, who were his wife and father-in-law, [Christopher] McCutcheon has caused QBR's financial statements to be incorrect and incomplete and has consistently failed to update QBR's financial statements on the company's accounting system, Peachtree," Hornbuckle's attorney stated as part of the reason for the counterclaim.

Christopher McCutcheon denied allegations he caused harm to QBR in an answer to Hornbuckle's counterclaim in October 2016. The civil claim was eventually settled in April 2017.

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