Kusserow’s Corner: Doctor Indicted for Role in $158 Million Medicare Fraud Scheme

Dr. Sharon Iglehart, a Houston doctor, has been arrested on charges related to her alleged participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment. According to the indictment, she allegedly participated in a scheme to defraud Medicare beginning in 2005 and continuing until May 2012. The indictment alleges that the defendant and her co-conspirators submitted or caused to be submitted approximately $158 million in claims to Medicare for partial hospitalization program (PHP) services purportedly provided by the hospital, when in fact the PHP services were medically unnecessary or never provided. A PHP is a form of intensive outpatient treatment for severe mental illness. Claims were submitted fraudulently for PHP services to Medicare through a Houston hospital.

This case is related to Mohammad Khan, an assistant administrator at the hospital who managed many of the hospital’s PHPs. He pleaded guilty to his participation in the scheme and is awaiting sentencing. Others involved in the scheme included Earnest Gibson III, the administrator of the hospital, along with Earnest Gibson IV, William Bullock III, Robert Ferguson, Regina Askew, Leslie Clark and Robert Crane, who were previously indicted for their roles in the scheme. Clark pleaded guilty but has not yet been sentenced.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2013 Strategic Management Services, LLC. Published with permission.