Former president of Riverside General Hospital convicted in $158M Medicare fraud scheme

Earnest Gibson III, the former president of Riverside General Hospital in Houston, has been convicted for his participation in a $158 million Medicare fraud scheme involving false claims, 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 serves for Medicare beneficiaries who did not qualify for the treatment. In addition, the beneficiaries rarely saw a psychiatrist and they did not receive the PHP services.

The evidence also showed Mr. Gibson paid kickbacks to Ms. Askew and other owners and operators of group care homes for providing Medicare beneficiaries who were not eligible for PHP services to RGH.

"Some patients just watched television all day, others had dementia and couldn't understand the therapy they supposedly received, and other patients never even went to the hospital at all," said Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division.

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.

The federal jury that found Mr. Gibson guilty also convicted his son and two others for their participation in the scheme. Ten defendants have been convicted in connection with the fraud scheme at RGH.

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