Texas Physician Indicted in Alleged $158 Million Medicare Fraud Scheme

January 16, 2014 — The U.S. Justice Department(DOJ) depends on whistleblowers to help recover some of the millions of dollars misspent each year due to unscrupulous Medicare scams. The qui tam provisions in the False Claims Act give health care informants a powerful weapon for combating fraud in their industry. Tipsters are empowered to file a claim for the government’s benefit and retain a portion of the proceeds should the government make a recovery.

A Texas physician has been arrested in an alleged $158 million Medicare fraud operation involving false claims for mental health treatment, the DOJ has announced.

Between 2005 and 2012, Sharon Iglehart, of Houston, Texas, allegedly took part in a scheme to defraud Medicare by submitting false claims for partial hospitalization program (PHP) services purportedly provided through a Houston hospital. A PHP is a type of intensive outpatient treatment for patients with severe mental illness. Iglehart and her co-conspirators allegedly caused the submission of $158 million in false claims to Medicare for PHP services that were medically unnecessary or not, in fact, provided.

Mohammad Khan, a hospital assistant administrator who handled many of the hospital’s PHPs, has already been indicted and pleaded guilty for his part in the operation. Several others have also been indicted in connection with the Medicare fraud scam, including Earnest Gibson III, the hospital administrator, and others.

False Claims Act violations involving false claims to Medicare for PHP services are frequently revealed by health care employees. Tipsters who may be considering collaborating with the Justice Department should first learn everything they can about the process. The qui tam lawyers with Waters & Kraus provide brave whistleblowers the legal counsel they deserve. Contact us or call our False Claims Act attorneys at 855.784.0268 to speak with us about our health care fraud practice.