Less than a month after the former assistant administrator of Riverside General Hospital was sentenced to 40 years in prison for his role in a $116 million fraud scheme, the president of the hospital has received 45 years for billing Mediare $158 million for mental healthcare that was never provided, according to a Department of Justice release.
Last fall, Earnest Gibson III was convicted of conspiracy to commit healthcare fraud for defrauding Medicare by submitting false claims for partial hospitalization program (PHP) services, along with his son, Earnest Gibson IV, and Regina Askew, the owner of Safe and Sound group home.
The younger Gibson, who operated a satellite psychiatric facility associated with Riverside, was also sentenced to 20 years for his role in the scheme, and Askew will serve 12 years. Both Askew and the elder Gibson are each required to pay more than $46 million in restitution.
"The former president of Houston's Riverside hospital, his son and their co-conspirators saw mentally ill, elderly and disabled Medicare beneficiaries as commodities to be turned into profit centers--not as vulnerable individuals in need of healthcare," Assistant Attorney General Leslie Caldwell said in the release. "Rather than providing needed medical care to a historically underserved community, the defendants ran a longstanding hospital into the ground through their greed and fraud."
According to evidence presented during the trail, the father-son duo paid kickbacks to patient recruiters and group home operators in exchange for mental health referrals, which they used to fraudulently bill Medicare for PHP services. In reality, those patients were often watching television rather than engaging in mental health therapy.
Mental health services have historically been hotspots for Medicare and Medicaid fraud, and the Texas Health and Human Services Commission has repeatedly come under fire for failing to detect or prevent healthcare fraud schemes.
To learn more:
- here's the release