67-year-old Houston psychiatrist Riyaz Mazcuri, along with his associates at Riverside General Hospital, will be spending the next decades of their lives in prison for their roles in a $155 million Medicare fraud case.

U.S. District of Texas Judge Vanessa D. Gilmore sentenced Mazcuri to 150 months in prison, as well as a restitution of $20,607,410 to Medicare and a $2,250,789 restitution to Medicaid.

Mazcuri Billed Medicare For Psychiatric Services He Never Provided

Mazcuri, a former attending psychiatrist at Riverside General Hospital in Houston, was found to have participated in a fraudulent scheme to receive Medicare payments for psychiatrist services he never provided. Between 2006 and 2012, Mazcuri filed financial claims for an intensive outpatient treatment regimen for patients with severe mental illness. The treatment service is known as partial hospitalization program (PHP).

The psychiatrist enabled Riverside to bill Medicare for more than $55 million worth of fraudulent services. Mazcuri carried out his scheme by admitting and re-admitting patients into PHP services for years on end–patients who were not qualified for PHP programs in the first place.

Medical and court evidence revealed that Mazcuri signed false papers and falsified medical documents so that auditors would believe the patients qualified for, required, and received intensive psychiatric treatments among other PHP services.

That is not all: Mazcuri received Medicare payments for psychiatric treatments he neglected to even provide to Riverside’s PHP patients.

15 Others Received Prison Sentences for Defrauding Medicare via the PHP Scam

Mazcuri was not the only one who participated in the Medicare fraud through Riverside. 15 other people were convicted for their roles in the scam, including:

  • Earnest Gibson III, 73 – former Riverside President, 45 years in prison
  • Earnest Gibson IV, 41 – Manager of a Riverside PHP satellite office, 20 years in prison
  • Regina Askew, 53 – group home owner and patient file auditor, 12 years
  • Robert Crane, 61 – Patient Recruiter, sentence pending
  • Mohammad Khan, 68 – Assistant Administrator at Riverside, 40 years
  • Sharon Iglehart, 61 – physician at Riverside, 12 years
  • Walid Hamoudi, 66 – physician at Riverside, 5 years

Former Assistant Chief Ashlee Caligone McFarlane and trial attorneys Aleza Remis and Kevin Lowell of the Department of Justice Criminal Division Fraud Section prosecuted the case with help from the FBI and other anti-fraud agencies.

A Look at the $60 Billion Industry of Medicare Fraud

 

 

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