Industry News

Owners of a Mental Health Clinic Sentenced for $97 Million Medicare Fraud Scheme.

Two physician owners of Spectrum Care, P.A. (Spectrum), a community mental health clinic received a prison sentence of 148 months and 120 months, respectively, for their participation in a $97 Million Medicare fraud scheme.  A group home owner also received a prison sentence of 54 months for her involvement in the scheme.

The owners of Spectrum allegedly paid kickbacks to group care home operators and patient recruiters in exchange for delivering ineligible Medicare beneficiaries to Spectrum.  In certain instances, patients received a fraction of the kickbacks.  The evidence presented at trial demonstrated that the owners signed admission documents and progress notes certifying that patients qualified for partial hospitalization program services, when the patients did not qualify.  The owners also billed for services when beneficiaries were watching movies and playing games.

Federal and state agencies investigated the case, brought as part of the Medicare Fraud Strike Force, and supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.

The Department Of Justice news release is available at:

Department of Justice.  “Physician Owners of Mental Health Clinic Sentenced for $97 Million Medicare Fraud Scheme.”  Justice News.  12 Jan. 2015.