Operator of Psychiatric Facility Sentenced to 20 Years in
Prison, and Owner of Group Home Sentenced to 12 Years in Prison
The former president of a Houston hospital, his son and a
co-conspirator were sentenced today to 45 years, 20 years and 12 years in prison,
respectively, for their roles in a $158 million Medicare fraud scheme.
Assistant Attorney General Leslie R. Caldwell of the Justice
Department’s Criminal Division, U.S. Attorney Kenneth Magidson of the Southern
District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s
Houston Field Office, Special Agent in Charge Lucy R. Cruz of the Internal
Revenue Service Criminal Investigation’s (IRS-CI) Houston Field Office, the
Texas Attorney General’s Medicaid Fraud Control Unit (MFCU), Special Agent in
Charge Mike Fields of the U.S. Department of Health & Human Services-Office
of the Inspector General (HHS-OIG) Dallas Regional Office, Special Agent in
Charge Joseph J. Del Favero of the Railroad Retirement Board-Office of
Inspector General (RRB-OIG) and Inspector General Patrick E. McFarland of the
Office of Personnel Management-Office of Inspector General (OPM-OIG) made the
announcement.
“The former President of Houston's Riverside hospital, his
son and their co-conspirators saw mentally ill, elderly and disabled Medicare
beneficiaries as commodities to be turned into profit centers – not as
vulnerable individuals in need of health care,” said Assistant Attorney General
Caldwell. “Rather than providing needed
medical care to a historically underserved community, the defendants ran a longstanding
hospital into the ground through their greed and fraud. According to the evidence presented at trial,
the defendants had patients sit around the facility watching movies while they
received no treatment. Meanwhile, the
defendants billed Medicare more than $158 million for care that was never
provided. This brazen fraud cannot and
will not be tolerated.”
Earnest Gibson III, 70, the former president of Riverside
General Hospital, Earnest Gibson IV, 37, the operator of Devotions Care
Solutions, a satellite psychiatric facility of Riverside General Hospital, and
Regina Askew, 50, the owner of Safe and Sound group home, were sentenced by
U.S. District Judge Lee H. Rosenthal of the Southern District of Texas. In addition to the significant terms of
imprisonment, Earnest Gibson III was ordered to pay restitution in the amount
of $46,753,180, Earnest Gibson IV was ordered to pay restitution in the amount
of $7,518,480, and Regina Askew was ordered to pay restitution in the amount of
$46,255,893.
Following a five-week jury trial, on Oct. 20, 2014, Earnest
Gibson III, Earnest Gibson IV and Regina Askew each were convicted of
conspiracy to commit health care fraud, conspiracy to pay and receive
kickbacks, as well as related counts of paying or receiving illegal kickbacks. Earnest Gibson III and Earnest Gibson IV also
were convicted of conspiracy to commit money laundering. Co-defendant Robert Crane, a patient
recruiter, also was convicted of conspiracy to pay and receive kickbacks, and
is scheduled to be sentenced on Dec. 9, 2015.
According to evidence presented at trial, from 2005 until
June 2012, the defendants and others engaged in a scheme to defraud Medicare by
submitting to Medicare, through Riverside and its satellite locations,
approximately $158 million in false and fraudulent claims for partial
hospitalization program (PHP) services.
A PHP is a form of intensive outpatient treatment for severe mental
illness.
Specifically, evidence at trial demonstrated that the
Medicare beneficiaries for whom the hospital billed Medicare did not qualify
for or need PHP services. Moreover, the
evidence showed that Medicare beneficiaries rarely saw a psychiatrist and did
not receive intensive psychiatric treatment.
In fact, some of the beneficiaries were suffering from Alzheimer’s and
could not actively participate in the treatment for which Medicare was billed.
Evidence presented at trial also showed that Earnest Gibson
III paid kickbacks to patient recruiters and to owners and operators of group
care homes, including Regina Askew, in exchange for which those individuals
delivered ineligible Medicare beneficiaries to the hospital’s PHPs. Earnest Gibson IV also paid patient
recruiters, including Robert Crane and others, to deliver ineligible Medicare
beneficiaries to the specific PHP operated by Earnest Gibson IV.
To date, six other individuals either have pleaded guilty
based on their involvement in the scheme.
Mohammad Khan, an assistant administrator at Riverside, who managed many
of the hospital’s PHPs, pleaded guilty to conspiracy to commit health care
fraud, conspiracy to defraud the United States and to pay illegal kickbacks,
and five counts of paying illegal kickbacks; on May 21, 2015, Mohammad Khan was
sentenced by U.S. District Judge Sim Lake of the Southern District of Texas to
40 years in prison for his role in the scheme.
William Bullock, an operator of a Riverside satellite location, as well
as Leslie Clark, Robert Ferguson, Waddie McDuffie and Sharonda Holmes, who were
involved in paying or receiving kickbacks, also have pleaded guilty to
participating in the scheme and await sentencing.
The case was investigated by the FBI, IRS-CI, Texas MFCU,
HHS-OIG, RRB-OIG and OPM-OIG. The case
was brought as part of the Medicare Fraud Strike Force, under the supervision
of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the
Southern District of Texas. The case is
being prosecuted by Assistant Chiefs Laura M.K. Cordova and Jennifer L. Saulino
and Trial Attorney Ashlee C. McFarlane of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike
Force, now operating in nine cities across the country, has charged nearly
2,100 defendants who collectively have billed the Medicare program for more
than $6.5 billion. In addition, the HHS
Centers for Medicare & Medicaid Services, working in conjunction with the
HHS-OIG, are taking steps to increase accountability and decrease the presence
of fraudulent providers.
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