Dive Brief:
- The Federal Bureau of Investigation announced that an operator of community health centers in Louisiana and a patient recruiter from Texas have been sent to prison for a Medicare fraud scheme that totaled to $258 million in inappropriate claims.
- Roslyn F. Dogan, the health center operator, both encouraged patients to seek treatment in partial hospitalization programs in full knowledge that they did not need psychiatric care and directed staff to alter records to indicate that patients received care when in fact they did not. James R. Hunter, the recruiter, recruited people who were ineligible for partial hospitalization in exchange for cash payments of $75 per week.
- Dogan and Hunter are two of 17 total people to be convicted in this case, including psychiatrist Zahid Imran, MD, co-owner of the Louisiana community health centers and the Texas facility.
Dive Insight:
Leveraging partial hospitalization programs for Medicare fraud seems to be an emerging trend. Last month, four individuals—former president of Riverside Hospital, Earnest Gibson III, his son, Earnest Gibson IV, Regina Askew and Robert Crane—were convicted for taking $158 million in Medicare funds for psychiatric care that was not rendered at the Texas institution. And according to Assistant US Attorney Ted Radway, there has been an "explosion of fraud in community-based treatments."