Mohammad Khan, $116 Million Medicare Fraud, Texas 2012

State: Texas
Category: Healthcare Fraud
Source: <a href="https://www.justice.gov/archives/opa/pr/assistant-administrator-riverside-general-hospital-sentenced-40-years-prison-116-million" style="color:#cc0000;" target="_blank" rel="nofollow noopener">DOJ Press Release ÃƒÂ¢Ã¢â‚¬Â Ã¢â‚¬â€

A former assistant administrator of Riverside General Hospital in the Southern District of Texas has been sentenced to 40 years in prison for his role in a $116 million Medicare fraud scheme.

Mohammad Khan, 65, of Houston, pleaded guilty in February 2012 to conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks, and paying illegal kickbacks.

According to the U.S. Attorney Kenneth Magidson, Khan and others at Riverside General Hospital operated a scheme to defraud Medicare by submitting claims for partial hospitalization programs (PHPs) that were not medically necessary and, in some cases, never provided.

Between January 2008 and February 2012, Khan and his co-conspirators paid kickbacks to patient recruiters and owners of group care homes in exchange for delivering ineligible Medicare beneficiaries to the hospital’s PHPs.

As a result of the scheme, Riverside General Hospital submitted over $116 million in claims to Medicare for PHP services that were medically unnecessary or never provided. Khan was also ordered to pay restitution in the amount of $31,321,200.

Khan is the 10th individual to plead guilty or be convicted in connection with the scheme. Others involved include Earnest Gibson III, the former president of Riverside General Hospital; his son, Earnest Gibson IV; Regina Askew, a patient file auditor and group home operator; and Robert Crane, a patient recruiter.

The case was investigated by the FBI, Internal Revenue Service Criminal Investigation, and Texas Attorney General’s Medicaid Fraud Control Unit, with assistance from the Health & Human Services’ Office of the Inspector General.

The case was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Texas.

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