Medicare Scam Unravels for Houston Hospital Execs
A federal jury in Houston has convicted the president of Riverside General Hospital, Earnest Gibson III, his son Earnest Gibson IV, and two others, for their participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment. The scheme, which lasted from 2005 to 2012, targeted mentally ill and disabled Americans, treating them as ‘chits to be traded and cashed out’ to pad their own pockets, said Assistant Attorney General Leslie R. Caldwell. Ten defendants have now been convicted in connection with the Riverside fraud scheme.
The defendants, including Earnest Gibson III, 70, Earnest Gibson IV, 37, and Regina Askew, 49, were convicted of conspiracy to commit health care fraud and conspiracy to pay kickbacks, as well as related counts of paying and receiving illegal kickbacks. Robert Crane, 58, a patient recruiter, was convicted of conspiracy to pay and receive kickbacks. Gibson III and Gibson IV were also convicted of conspiracy to commit money laundering.
The evidence presented at trial showed that the Medicare beneficiaries for whom Riverside and its satellite locations billed Medicare for PHP services did not qualify for or need PHP services. In fact, some of the Medicare beneficiaries were suffering from Alzheimer’s and could not actively participate in any treatment even if they actually qualified to receive PHP services.
Earnest Gibson III paid kickbacks to patient recruiters and to owners and operators of group care homes, including Askew, in exchange for those individuals delivering ineligible Medicare beneficiaries to the hospital’s PHPs. Gibson IV also paid patient recruiters, including Crane and others, in exchange for those individuals delivering ineligible Medicare beneficiaries to the specific PHP operated by Gibson IV.
Approximately $158 million in claims to Medicare were submitted for PHP services purportedly provided by the hospital to the recruited patients. U.S. District Judge Lee H. Rosenthal presided over the trial, which was announced by Assistant Attorney General Leslie R. Caldwell, U.S. Attorney Kenneth Magidson, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge Lucy R. Cruz of the Internal Revenue Service – Criminal Investigation’s (IRS-CI) Houston Field Office and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).
The guilty verdict sends a powerful message that the government will hold accountable anyone who seeks personal profits at the expense of America’s most vulnerable citizens, said Caldwell. The case is a stark reminder of the devastating consequences of Medicare fraud, which not only harms patients but also wastes taxpayer dollars.
The convictions bring to ten the number of defendants who have been convicted in connection with the Riverside fraud scheme. The case is a testament to the tireless efforts of law enforcement agencies and prosecutors to root out Medicare fraud and bring those responsible to justice.
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Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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