Bobby Rouse, Health Care Fraud, Texas 2020

HOUSTON, Texas - A Houston man has been convicted in a massive health care fraud scheme that bilked Medicare and Medicaid out of nearly $250 million.

Bobby Rouse, 80, pleaded guilty to conspiring to pay and receive kickbacks and to money laundering relating to the Medicare program.

Rouse admitted to participating in a kickback scheme to pay co-defendants to bring patients to Continuum Healthcare LLC, a company he was part of the executive team for. Continuum owned Westbury Community Hospital in Houston as well as community mental health centers in the Houston area.

The scam involved a partial hospitalization program (PHP) that was supposed to be a treatment program for individuals with mental illness. However, the program offered less than 24-hour daily care and was not suitable for the vast majority of patients. Rouse and his co-defendants paid kickbacks to marketers and personal care home owners to refer patients to the program.

The scheme involved 13 other defendants, including several members of the Continuum executive team. The total amount billed to Medicare and Medicaid was approximately $189 million, with Medicare paying out $123 million and Medicaid paying out $66 million.

Rouse faces up to 10 years in prison and a possible $250,000 maximum fine. He is set to be sentenced on January 23, 2020.

The case was investigated by the FBI, Department of Health and Human Services - Office of the Inspector General, Texas Attorney General's Medicaid Fraud Control Unit and IRS - Criminal Investigation. Assistant U.S. Attorneys Tina Ansari and Special Assistant U.S. Attorney Justin Blan are prosecuting the case.

Source: https://www.justice.gov/usao-sdtx/pr/final-defendant-convicted-189-million-health-care-fraud-scam