Texas Psychiatrist Riaz Mazcuri Gets 12 Years Prison for $155M Medicaid Fraud Scam

September 7, 2018

A Texas psychiatrist was sentenced to more than 12 years in prison this week for his role in a $155 million Medicare fraud scheme that ensnared top executives and clinicians at Houston's Riverside General Hospital, the Department of Justice said.

Riyaz Mazcuri, 67, a former psychiatrist at Riverside, was convicted by a federal jury in 2017 on charges that included five counts of healthcare fraud. He was also ordered to pay $20.6 million in restitution to Medicare and $2.2 million to Medicaid.

At his 2017 trial, prosecutors showed that Mazcuri and others at Riverside submitted more than $155 million in bogus claims to Medicare between 2006 and 2012, using the hospital's partial hospitalization program for patients with severe mental illness.

Prosecutors showed that Mazcuri "indiscriminately admitted and readmitted patients into these intensive psychiatric programs–often for years on end–many of whom suffered from severe Alzheimer's or dementia and were unable to participate in the treatment purportedly provided at the PHPs, and who therefore did not qualify for the services," DOJ said. The psychiatrist falsified medical records and signed false documents to make it appear as if patients admitted to the PHPs needed and received the intensive psychiatric services. He also personally billed Medicare for psychiatric treatment he purportedly provided to Riverside's PHP patients—treatment he never actually provided.

All totaled, Mazcuri's signature enabled Riverside to bill Medicare for more than $55 million of the total $155 million that Riverside billed Medicare.

Sixteen executives, clinicians and assorted scammers have been convicted for their roles in the Riverside fraud, including Earnest Gibson III, 73, the former president of Riverside; Earnest Gibson IV, 41, the operator of one of Riverside’s PHP satellite locations. Earnest Gibson III was sentenced to 45 years in prison. Earnest Gibson IV was sentenced to 20 years in prison. Mohammad Khan, 68, an assistant administrator at the hospital, who managed many of the hospital’s PHPs, was sentenced to 40 years in prison. Sharon Iglehart, 61, a physician, was sentenced to 12 years in prison. Walid Hamoudi, 66, a physician, was sentenced to five years in prison. Riverside—Houston's first nonprofit hospital for African Americans—was shuttered soon after the scandal broke in 2012. Harris County (TX) Commissioners voted this spring to buy the hospital and reopen it as a mental health facility.

Source: "HOUSTON PSYCHIATRIST GETS 12 YEARS IN PRISON FOR $155M MEDICARE FRAUD," Health Leaders, September 5, 2018, URL: https://www.healthleadersmedia.com/clinical-care/houston-psychiatrist-gets-12-years-prison-155m-medicare-fraud