Houston Psychiatrist Sentenced to 144 Months in Prison for Role in $158 Million Medicare Fraud Scheme
The government’s crackdown on Medicare fraud has resulted not just in hefty fines for those who have been convicted but it has also resulted in substantial prison sentences as well. This was demonstrated earlier this month, when the US Justice Department – in conjunction with several other agencies – announced that a Houston psychiatrist had been sentenced to 144 months in prison for her role in $158 million scheme to defraud Medicare. The psychiatrist – Sharon Iglehart, a former psychiatrist at Riverside General Hospital – was sentenced by U.S. District Judge Ewing Werlein Jr. In addition to her sentence, Iglehart was also ordered by Werlein to pay $6,363,528.82 in restitution and to forfeit the same amount. On Sept. 10, 2015, following a seven-day trial, a jury convicted Iglehart of one count of conspiracy to commit health care fraud, one count of health care fraud and three counts of making false statements relating to health care.
According to the government from 2006 until 2012, Iglehart, et al., defrauded Medicare by submitting through her hospital, approximately $158 million in false claims. These claims were submitted to Medicare for its partial hospitalization program (PHP) services. (The program treats mentally ill patients on an outpatient basis.) The evidence showed that the beneficiaries, for who Riverside billed Medicare, did not receive PHP services. Moreover, it was proven that most beneficiaries rarely saw, nor did they receive treatment from, a psychiatrist. Additional evidence showed that Iglehart billed Medicare for individual psychotherapy and other treatments for her patients at Riverside that she never provided. Furthermore, Iglehart falsified patient records at Riverside to make it appear as if she had provided treatment to those patients.
To date, twelve other individuals have been convicted based on their roles in the scheme. The persons involved include Riverside’s former president, the operator of one of its satellite locations, a patient file auditor, a patient recruiter and others. The sentences range from 12 to 40 years in prison for each. The FBI, HHS-OIG, IRS-CI and the MFCU investigated the case with assistance from the Railroad Retirement Board’s Office of Inspector General and others. The convictions came about as a result of the government’s crackdown on Medicare Fraud. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion. The government has aggressively pursued individual and organizations involved in these fraudulent activities. To this end, it has encouraged that any Medicare fraud whistleblowers come forward and report such incidences through its Medicare fraud hotline. The public is also encouraged to report abuse to the Health Care Fraud Prevention and Enforcement Team (HEAT), by going to www.stopmedicarefraud.gov.