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Former Doctor Pleads Guilty in $19M Texas Health Care Scam
Houston, Texas – In a shocking case of health care deceit, Donald Gibson II, a 56-year-old former doctor from Richmond, Texas, pleaded guilty to conspiracy to commit health care fraud. Gibson, along with his co-defendant Sunday Joseph Edem, 53, also of Richmond, conspired to commit health care fraud from January 2007 through January 2012.
According to the investigation, Gibson ordered, prescribed, and authorized medically unnecessary diagnostic tests and procedures, including allergy tests, pulmonary function tests, vestibular tests, urodynamic tests, and physical therapy, among others. These services were then billed to Medicare and Medicaid under Gibson’s billing number, causing more than $19.4 million in medical claims. As a result, Medicare deposited approximately $8.5 million into a bank account owned and controlled by Gibson.
Gibson’s scheme involved paying patient recruiters for referring Medicare/Medicaid beneficiaries and also paying Medicare beneficiaries for showing up at the medical clinics. Edem operated medical clinics under the names of other individuals to conceal his financial interest in the businesses. Both Gibson and Edem conspired to cause the submission of false claims to the Medicare and Medicaid programs and share in the proceeds.
Gibson is set to be sentenced on July 1, 2013, where he faces up to 10 years in federal prison and a possible $250,000 fine. Edem, who also pleaded guilty to the same charge, is scheduled to be sentenced on May 28, 2013.
The investigation was a joint effort involving multiple federal and state agencies, including the U.S. Department of Health and Human Services – Office of Inspector General, Railroad Retirement Board, Secret Service, Drug Enforcement Administration, FBI, and the Texas Attorney General’s Medicaid Fraud Control Unit.
Special Assistant U.S. Attorney Justin Blan and Assistant U.S. Attorney Andrew Leuchtmann are prosecuting the case. Gibson’s conviction serves as a stark reminder of the importance of holding accountable those who seek to exploit the healthcare system for personal gain.
Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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