Earnest Gibson III, the former president of Riverside General Hospital in Houston, has been sentenced to 45 years in prison and ordered to pay nearly $46.8 million in restitution for his role in a $158 million Medicare fraud scheme, according to the Department of Justice.
From 2005 to 2012, Mr. Gibson, his son, and Regina Askew — a group home owner — were involved in a scheme to defraud Medicare that involved submitting false claims for partial hospitalization program services through RGH. PHP services involve intensive outpatient treatment for severe cases of mental illness.
Evidence presented at trial showed RGH and its satellite locations billed Medicare for PHP services for Medicare beneficiaries who did not qualify for or need the treatment, according to the DOJ.
The evidence also showed Mr. Gibson paid kickbacks to Ms. Askew and other owners and operators of group care homes for delivering ineligible Medicare beneficiaries to the hospital for PHP services.
As a result of the scheme, approximately $158 million in claims for medically unnecessary PHP services or services that were never provided were submitted to Medicare.
In October 2014, Mr. Gibson, his son and two others were convicted for their participation in the scheme.
Mr. Gibson's son was sentenced to 20 years in prison and ordered to pay $7.5 million in restitution for his involvement and Ms. Askew was sentenced to 12 years in prison and ordered to pay restitution in the amount of $46.2 million, according to the DOJ.
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