Ex-Hospital CEO, Doctors Guilty of $400M in Medicare Fraud
By A number of different racketeers have been convicted of more than $400 million in fraudulent Medicare billings.
- The Attorney General’s Office has quashed a number of different high-value Medicare fraud schemes, and has convicted or sentenced several physicians, the founder of a home health agency, a physician assistant, and the former CEO of a community hospital for their roles in falsely billing the payer for more than $400 million in illegal payments.
Former Riverside Hospital leader, son, and others convicted for $158 million fraud
Earnest Gibson III, the former CEO of Riverside General Hospital in Houston, Texas, has been convicted for his role in receiving kickbacks from patient recruiters for directing patients to Riverside psychiatric clinics. His son, Earnest Gibson IV, and eight other defendants have been found guilty of participating in the six-year effort, which included the admission of seriously mentally ill patients for “intensive” treatments that never took place.
“The former president of Riverside hospital, his son, and their co-conspirators systematically defrauded Medicare, treating mentally ill and disabled Americans like chits to be traded and cashed out to pad their own pockets,” said Assistant Attorney General Leslie R. Caldwell. “Today’s verdict sends another powerful message that the department will hold accountable anyone who seeks personal profits at the expense of America’s most vulnerable citizens.”
Florida physician assistant gets 15 years for $200 million Medicare theft
Robert Bergman, a 65-year-old licensed physician assistant from Miami, has been sentenced to fifteen years in prison for his role in submitting $200 million in fraudulent billing for mental health provider American Therapeutic Corporation (ATC). Bergman and other co-conspirators were found guilty of signing false documentation to justify the inflated billings for patients who were ineligible for certain intensive treatments.
ATC, an additional management company, and more than 20 other individuals have either pled guilty or been convicted for their role in the fraud. Several of the co-conspirators, including Bergman, have been ordered to pay back more than $85 million.
Dermatologist bilks Medicare for $2.6 million in Chicago
Dr. Robert Kolbusz, a Chicago-area dermatologist, has been found guilty of defrauding Medicare and private insurers of $2.6 million by falsely diagnosing patients with potentially cancerous lesions, falsifying documentation, and providing ineffective treatments. Kolbusz is currently free on bond and will face sentencing in February. He has been convicted of wire fraud and mail fraud charges, each of which carries a maximum sentence of 20 years in prison.
Michigan home health agency founder pleads guilty to $22 million crime
The founder of three home health agencies in the Detroit, Michigan area, Tayyab Aziz, has pled guilty to defrauding Medicare of $22 million. Aziz admitted to submitting claims for services that were unnecessary or never provided, and was also involved in an illegal kickback scheme to recruit Medicare beneficiaries. Aziz and his co-conspirators also created false documentation to hide their actions. Five out of six additional defendants have also pled guilty to the fraud.
Los Angeles fraudster dies before sentencing for $11 million equipment trial
Dr. Juan Tomas Van Putten pled guilty in November of 2012 to an $11 million fraud involving false prescriptions for power wheelchairs and other durable medical equipment, but has died before he could be sentenced or serve any time for the crime. While his conviction carried a possible sentence of ten years, prosecutors recommended a three-year stint in prison due to Van Putten’s assistance in uncovering the actions of his co-defendents. Van Putten suffered from kidney problems, court documents said, and died about two weeks before his sentencing hearing.
