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Hospital ex-CEO says he was unaware of Medicare fraud scheme

by | Nov 14, 2015 | Health Care Fraud

Former president faces up to 80 years in prison after conviction

The former president of a Houston hospital has been convicted, along with three others, in a Medicare fraud scheme that prosecutors say totaled over $158 million, according to the Brownsville Herald. The four employees were charged with defrauding the government by applying for Medicare funding without providing the required care and treatment for patients. The ex-CEO, however, claims that he was unaware of any potential crimes occurring on the ground level at the facility and says he never even met some of the people who are alleged to have carried out the crimes.

Fraud accusations

The federal government accused workers at the hospital of charging the government $158 million in fraudulent Medicare funding. Prosecutors alleged that the hospital’s psychiatric treatment was a “sham,” according to the Houston Chronicle.

Specifically, the hospital was accused of charging the government for treatment sessions even when patients did not show up or sat in their rooms watching television. Other employees at the hospital had already pled guilty to similar charges in an effort to have their sentences reduced.

Up to 80 years in prison

Although the alleged Medicare fraud resulted in four convictions recently, it is the ex-CEO of the hospital who faces the worst punishment. The charges on which he has been convicted carry a maximum prison term of 80 years, although it is likely that he will be sentenced for a shorter period than that. Sentencing for all four will be decided in February.

The ex-CEO claims that he has been made a scapegoat for problems that happened at the hospital, which has suffered from financial problems in recent years. He claims that many of the alleged criminal activities occurred on the ground level and involved employees he had never met let alone worked with in order to defraud the government. He has indicated that he will fight the conviction.

Healthcare fraud

In recent years, federal authorities have begun cracking down on healthcare fraud and, as the above case shows, people convicted of such fraud could face heavy sentences. Medicare and Medicaid fraud can not only ruin a person’s career and reputation, but they can lead to years behind bars.

Anybody who is facing a healthcare fraud investigation needs the help of a defense attorney right from the beginning. Such cases are often complex and require legal representation experienced in how healthcare fraud cases typically function. A qualified attorney can provide clients with the advice they need to vigorously defend these allegations.