Industry News

Patient Broker Sentenced to 24 Months in Prison for Role in $67 Million Medicare Fraud Scheme.

Jennifer Kirchner | November 2013

A patient broker for a psychiatric facility in southern Florida was sentenced to serve 24 months in prison and ordered to pay $14 million, jointly and severally with her co-defendants, for her role in a $67 million Medicare fraud scheme.  The broker, Gloria Himmons, provided Medicare beneficiaries to the facility, Hollywood Pavilion LLC (HP), in return for bribes and kickbacks, knowing that the patients she referred were not appropriate for inpatient psychiatric hospitalization or for outpatient mental health treatment.  From at least 2005 through September 2012, Himmons provided patients to HP who were not severely mentally ill, including substance abusers looking for rehabilitation programs, who did not have legitimate referrals from hospitals or doctors. 

Three other defendants were convicted in the scheme, including the chief executive officer of HP.  The chief executive officer was sentenced to 300 months in prison and ordered to pay nearly $40 million in restitution, jointly and severally with her co-defendants. The case was investigated by the Federal Bureau of Investigation and Department of Health and Human Services Office of Inspector General as part of the Medicare Fraud Strike Force. 

The Department of Justice news release is available at:

http://www.justice.gov/opa/pr/2013/November/13-crm-1184.html.

Department of Justice.  “Patient Broker of South Florida Psychiatric Hospital Sentenced for Role in $67 Million Health Care Fraud Scheme.” Justice News. 6 Nov. 2013.

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.