The former president of a Houston hospital, his son and a third person were sentenced to prison Tuesday for billing Medicare $158 million for mental health services that were medically unnecessary or never provided.
Earnest Gibson III, the former president of Riverside General Hospital; his son Earnest Gibson IV, who operated one of the hospital's satellite locations; and Regina Askew, a group-home owner, were convicted in October of conspiracy to commit healthcare fraud, conspiracy to pay kickbacks and related counts of paying and receiving illegal kickbacks. The Gibsons also were convicted of conspiracy to commit money laundering, according to a U.S. Justice Department release.
The elder Gibson was sentenced to 45 years in prison and his son was sentenced to 20 years. Askew was sentenced to 12 years in prison.
Dick DeGuerin, an attorney for the elder Gibson, said Tuesday he's frustrated the federal sentencing guidelines were applied in “such a harsh manor.”
“Perhaps more importantly I'm frustrated with the government's efforts to prosecute criminally violations of policy and procedures rather than real criminal acts,” DeGuerin said. “It seems to me that the partial hospitalization program is fraught with traps for the unwary where mere failure to follow procedures can end up in criminal court, things that would ordinarily be handled by either a refund or a civil penalty.”
Attempts to reach attorneys for Earnest Gibson IV and Askew were not immediately successful Tuesday afternoon.
Earnest Gibson III was also ordered to pay restitution of $6,753,180; Earnest Gibson IV was ordered to pay restitution of $7,518,480; and Askew was ordered to pay $46,255,893.
Between 2005 and 2012, Riverside and its satellite locations billed Medicare for partial hospitalization program services for Medicare beneficiaries who did not need or qualify for the services, which are a form of intensive outpatient treatment for severe mental illness, the Justice Department said.
The beneficiaries rarely saw psychiatrists and did not receive intensive psychiatric treatment. Some were suffering from Alzheimer's, meaning they couldn't have participated in treatment even had they qualified for it.
Earnest Gibson III also paid kickbacks to patient recruiters, owners and operators of group-care homes, including Askew, in exchange for them sending ineligible Medicare patients to the hospital's partial hospitalization programs, according to the government. Earnest Gibson IV also paid patient recruiters to do the same for his program, prosecutors said.
Proceeds from the fraud were used to further the scheme by paying kickbacks to patient recruiters and group-home owners for sending their Medicare beneficiaries to the programs, according to the government.
A number of other individuals have also pleaded guilty in connection with the fraud.