Hospital Administrator Gets 40 Years in Prison for Medicare Fraud
In May, the former assistant administrator of Riverside General Hospital was sentenced to 40 years in prison for his participation in a massive Medicare fraud scheme. His sentencing followed a guilty plea that he and others at the hospital committed Medicare fraud by paying illegal kickbacks to recruit Medicare patients and then billed for partial hospitalization program services that were either not medically necessary or, in many instances, never provided at all. The defendant pled guilty to conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks and paying illegal kickback. This scheme involved paying kickbacks to recruiters and group home operators to provide the hospital with intelligible patients for the hospital’s partial hospitalization program. Thus far, at least ten people have been convicted for their participation in the scheme which falsely billed $116 million to the Medicare program. Others convicted in the scheme included the owners of the hospital, a patient file auditor and a paid patient recruiter.
The criminal case was the result of an investigation involving the FBI, the Texas Attorney General’s Medicare Fraud Control Unit and the Health and Human Services’ Office of the Inspector General, and was part of Medicare Fraud Strike Force. The case was prosecuted by the U.S. Attorney office in the Southern District of Texas