Medicare Unit Indicts 91 People for $429M in Alleged False Billing

HHS and the Department of Justice announced its Medicare Fraud Strike Force has charged 91 people — ranging from hospital administrators to physicians — for allegedly billing Medicare for $429.2 million in false claims.

The alleged activity occurred in seven different cities: Baton Rouge, La., Brooklyn, N.Y., Chicago, Dallas, Houston, Los Angeles and Miami. In total, more than $230 million was related to home healthcare fraud, $100 million to mental healthcare fraud and roughly $49 million to ambulance transportation fraud, among other areas.

One fraud scheme allegedly involved a hospital in Houston. Earnest Gibson III, CEO of Riverside General Hospital, his son and five others were charged with fraudulently billing $158 million for community mental health center services.

Mr. Gibson and others allegedly paid kickbacks in the form of cigarettes, food and coupons to Medicare beneficiaries in exchange for those beneficiaries' participation at RGH's partial hospitalization program. The beneficiaries allegedly watched television and played games instead of receiving services for which the hospital billed Medicare.

This is not the first time RGH has been in the spotlight for healthcare fraud. In February, former Assistant Administrator Mohammad Khan pleaded guilty to a $116 million kickback scheme, which also involved submitting false claims for PHP services.

For a full list of the federal government's indictments, click here.

More Articles on Medicare Fraud:

Wyoming Medical Center Agrees to $2.7M Settlement for Alleged Medicare Fraud

Cardiology & Medical Necessity: How Your Hospital Can Avoid Heart-Related Investigations

AHA Fights Back Against Allegations EHRs May Cause Upcoding Fraud

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