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Home » General » Resolution in Massive Medicare Fraud

Resolution in Massive Medicare Fraud

September 10, 2015General

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It’s been three years in the making and while there remain many unanswered questions, one defendant accused of playing a massive role in a $116 million fraudulent Medicare billing scheme has been sentenced. For a 65 year old man, it’s likely a death sentence.

You may recall Riverside General Hospital found itself at the center of this Medicare fraud scheme. The Texas hospital was accused of illegal billing practices and more than 12 people were arrested as part of that scheme.

One of those people, Mohammad Khan, 65, arrested first and now, sentenced first, received 40 years in prison. It was not the punishment he was expecting, especially considering he made a deal with the U.S. Justice Department that would mean a much lighter sentence in exchange for his cooperation.

That deal would not be completed until he testified in court, which never happened. There were at least four co-conspirators’ trials he could have testified, but he was never called by the prosecutors. He’s been in jail since his arrest three years ago.

This, by far, is one of the nation’s longest sentences for healthcare fraud, especially when it comes to the Medicare and Medicaid programs. It wasn’t until 8 months after Khan’s arrest that federal agents raided the hospital’s headquarters. Two arrests were made then, Earnest Gibson III, the CEO and administrator for thirty years, as well as his son, Earnest Gibson IV.

The father and son team were responsible for overseeing a satellite patient care facility. They were accused in three conspiracies involving Medicare billings for the hospital’s psychiatric treatment programs between 2005 and 2012. The government accused them of stealing more than $31 million by submitting illegal reimbursement requests. They were both found guilty, but have appealed their sentences. Even their sentences weren’t as harsh as Khan’s.
The federal prosecutor in this case, Laura M.K. Cordova, told the courts that the defendants treated “vulnerable people with mental illness, substance abuse and dementia like livestock”. When asked why Khan wasn’t allowed to testify, which could have reduced his sentence she explained, “We met with him many times. We provided him with an opportunity to provide truthful testimony and we did not feel that, under our ethical obligations to the court, that we could put him on as a witness”.

At his sentencing, Khan told the judge, “I was taking instructions from the Gibsons. It was very wrong. I wanted to help the government.” He then apologized to his family by saying, “I really feel so sorry and I feel lower than, really, a snake,” he said, in a last-ditch plea for leniency. “My age, it is like a death sentence. … I would like a chance to go back into the world.”

The judge was not swayed. “Medicare just pays out like a slot machine without any verification. … It’s ridiculous,” the judge said to the prosecutors before turning his attention back to Khan. “But that doesn’t excuse your crime. It just made your crime easier.” He said this should be a warning to anyone else attempting to defraud the government programs, which, he said is “essentially the American taxpayer.”

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Daniel DeBruyckere
Daniel DeBruyckere
Attorney Daniel A. DeBruyckere has been practicing law in New Hampshire and Massachusetts since 1998, and has helped hundreds of clients with their estate planning and elder care issues. He is very well respected in the area of estate planning, probate, trust administration, elder law issues, and business planning.
Daniel DeBruyckere
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