Texas psychiatrist latest person convicted in $158M Riverside Medicare fraud scheme

Money, handcuffs and a stethoscope
A Houston-area psychiatrist was found guilty for his role in a $158 million Medicare fraud scheme. (Getty/Alex_str)

A Houston-area psychiatrist is the latest person convicted for his role in a $158 million Medicare fraud scheme in which patients were admitted into intensive psychiatric programs.

After a five-day trial, Riaz Mazcuri, 65, of Harris County, Texas, was convicted by a federal jury of one count of conspiracy to commit healthcare fraud and five counts of healthcare fraud, according to an announcement from the U.S. Department of Justice. His sentencing is scheduled for October 10.

RELATED: Riverside sentencings should serve as warning shot to healthcare executives

Mental health services have historically been hotspots for Medicare and Medicaid fraud. According to evidence presented at trial, Mazcuri and others participated in a scheme in which Riverside General Hospital in Houston paid bribes and kickbacks to owners of group homes and nursing home employees in exchange for sending Medicare patients to its so-called partial hospitalization programs (PHP), a component of outpatient treatment for severe mental illness, the DOJ said. 

Mazcuri admitted and readmitted patients into these psychiatric programs, often for years on end, prosecutors said. Many of the patients had severe Alzheimer’s disease or dementia and were unable to participate in their own treatment and therefore did not qualify for the services. Riverside did not provide any of the services and falsified documents to make it appear that treatment was provided to patients, the announcement said.

Prosecutors said Mazcuri personally billed Medicare for more than $4.5 million for psychiatric treatment he claimed he provided to Riverside patients in those programs. He signed patient documents that allowed Riverside to bill Medicare for $55 million in fraudulent claims.

In addition to Mazcuri, 15 other people have been convicted to date in the scheme. Among them were another physician who was convicted after a jury trial and sentenced to 12 years in prison. A third doctor pleaded guilty and was sentenced to 5 years in prison. Three Riverside executives were sentenced to a total of 115 years in prison.

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