Federal agents raid mental health clinic in Medicare fraud probe

April 28, 2012

FBI agents Thursday morning raided a mental health clinic in the 6600 block of Hornwood that is owned by Westbury Community Hospital.
Photo: Johnny Hanson, Houston Chronicle

Federal agents with search warrants seized hundreds of patient records from a Houston psychiatric hospital and its two mental health clinics Thursday, part of an escalating Medicare fraud investigation into financial exploitation and care of the mentally ill as detailed last year by the Houston Chronicle.

The files, belonging to patients who attend counseling sessions at Westbury Community Hospital and its clinics in southwest Houston and Baytown, were boxed up and loaded into trucks in a pre-dawn swoop by the FBI and investigators from the Texas Attorney General's office.

Sources familiar with the investigation told the Chronicle the probe into Westbury is centered on the care of patients as well as whether owners of personal care homes were paid by hospital or clinic workers to recruit residents for treatment, whether they needed the care or not.

Billing totals obtained by the Chronicle show that more than $6.2 million in Medicare payments for mental health services were paid in 2010 to Westbury's clinic at 6614 Hornwood, then called Continuum Healthcare.

'It's unfair'

David Edson, Westbury's vice president of operations, and Jerry Skinner, the hospital's vice president of organization integrity and compliance, said Thursday that employees are grilled about whether they have ties to personal care homes or other health care providers and must sign a form attesting that they do not.

"If there were any (ties), we didn't know that, and we have attestations," Edson said.

"We're the most compliant group in the entire city," Skinner added.

No charges have been filed against the hospital or its employees.

"We are conducting a law enforcement activity," said Pat Villafranca, a FBI spokeswoman, who declined to offer further details.

Watching the federal and state agents work at Westbury's outpatient clinic in southwest Houston were Jeff Parsons, Westbury's CEO, and Colleen Paxton, administrator.

"It's unfair because it's disruptive," Parsons said of the investigators' presence. Some 140 patients arrive each day at the Hornwood clinic to participate in multi-hour, daily therapy. Their clients come mostly from assisted-living facilities and personal care homes, a type of unlicensed housing option found throughout Houston. "At the end of the day, I think we're fine."

Ambulances' role

During the Chronicle's investigation last year, dozens of private ambulances were seen daily delivering mostly mentally disabled residents from personal care homes and other facilities into the hands of mental health clinics.

The Westbury hospital and its clinic on Hornwood were frequent EMS destinations, though many of the patients were able-bodied and did not require an ambulance - also paid with Medicare dollars.

Records obtained by the Chronicle revealed that $62 million in Medicare money went to ambulance companies in Harris County in 2009 alone.

Patients interviewed by the paper could remember the type of food they ate at the clinics, or watching videos, but could not recall the therapy.

Recent arrests

Westbury's visit by the FBI marks the third time in the past five months that authorities have descended on clinics offering partial hospitalization program (PHP) services, a type of counseling that is not regulated by Texas, but paid for by Medicare.

In February, the administrator of the PHP program at Riverside General Hospital was arrested and charged in a $116 million Medicare billing scheme. Mohammad Khan pleaded guilty for his role in the arrangement, which involved kickbacks to patient recruiters and the owners of personal care homes in exchange for steering residents to Riverside's mental health clinics.

Khan, who is cooperating in the continuing investigation into Riverside, is scheduled to be sentenced in the fall.

Last December, the owners of Spectrum Care were arrested and charged in a $90 million Medicare billing scheme that involved accusations of phony treatment. Their case is pending. A third person, the owner of an assisted-living facility, was also charged after accusations of funneling patients to Spectrum Care in exchange for kickbacks from the clinic's owners.

Source: Terri Langford, "Feds seize mental health clinic records in Medicare fraud probe," Houston Chronicle, April 26, 2012.


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