A Houston hospital president and a Chicago dermatologist were among those charged in separate healthcare fraud cases that together netted more than $160 million in Medicare funds.
Earnest Gibson III, 70, served as president of Riverside Hospital in Houston until he and three other co-conspirators, including his own son, were found to have billed $158 million to Medicare for services that were unnecessary or never provided between 2005 and 2012.
Gibson and other Riverside healthcare workers paid kickbacks to patient recruiters and the owners of group-care homes so they would send patients to Riverside for mental healthcare they neither qualified for nor needed.
Proceeds from the fraudulent Medicare claims were used to fuel the system of kickbacks, the Department of Justice said.
Around the same time, Robert Kolbusz, a suburban Chicago dermatologist, was billing Medicare and private insurers $2.6 million for unnecessary care or care for which the recipients were unqualified.
Kolbusz falsely diagnosed hundreds of patients with skin lesions in order to justify ordering cosmetic treatments for them. He fraudulently claimed to have removed more than 150 lesions from patients between 2003 and 2010.
An Ohio physician pleaded guilty to prescribing hundreds of thousands of painkillers and other pills to patients who didn’t need them, even after learning some of his patients had died from overdosing on those drugs, on the same day Gibson and Kolbusz were convicted.
Adolph Harper, Jr., an Akron doctor, doled out prescriptions to patients he never examined or who displayed clear symptoms of drug addiction during visits to his office, court documents revealed.
“Doctor Harper is simply a drug dealer who happened to wear a white coat and worked from a medical office instead of a street corner,” Steven M. Dettelbach, U.S. attorney for the northern district of Ohio, said of the case.
In addition to his prescription abuse, Harper engaged in an insurance fraud scheme similar to those perpetrated by Gibson and Kolbusz. Justice Department officials said he billed insurance providers for services he never performed or for services for which he had already collected a cash payment.
Healthcare fraud costs taxpayers tens of billions of dollars every year. With growing national healthcare expenditures projected to exceed $3 trillion this year, fraud levels will continue to rise, according to the FBI.
