$97M Medicare Fraud Scheme Leads to 7 Convictions

A federal jury in Houston convicted two owners of Spectrum Care, a former mental health company, several of its employees, a patient recruiter and two group home owners for their participation in a $97 million Medicare fraud scheme.

The two owners of Spectrum Care orchestrated and executed a scheme to defraud Medicare beginning in 2006 and continuing until their arrest in 2011. 

Spectrum provided partial hospitalization program services, a form of intensive outpatient treatment for severe mental illness. As part of the fraud scheme, Spectrum billed Medicare $97 million for partial hospitalization program services for Medicare beneficiaries that did not qualify for or need the services, according to a Department of Justice report.

The owners of the group care homes involved in the scheme were paid kickbacks from the owners of Spectrum in exchange for delivering ineligible Medicare beneficiaries to Spectrum, and in some cases the patients received a portion of those kickbacks, according to the report.

More Articles on Medicare Fraud:

Just Before Trial Begins, Halifax Health Settles First Part of Fraud Case
Former Texas Hospital CFO Charged With Fraud
Halifax to Institute Internal Monitoring as Part of $85M Settlement 

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