Houston Psychiatrist Convicted Of Medicare Fraud

HOUSTON, TX — It was an audacious plan: submit fake claims for partial hospitalization services to Medicare, fill out a few forms, and wait for the payments to roll in. Only thing, they got caught.

Riaz Mazcuri, a 65-year-old psychiatrist from the Harris County, is the latest individual to be convicted in the $158 million scheme. He was convicted this week by a federal jury on one count of conspiracy to commit health care fraud and five counts of health care fraud. Mazcuri's sentencing is scheduled for October 10.

According to trial evidence, Mazcuri and others participated in a scheme that saw Riverside General Hospital pay bribes and kickbacks to owners of group homes and nursing home employees in exchange for them sending patients to Riverside for so-called partial hospitalization program (PHP) services. PHP services are a component of outpatient treatment for severe mental illness.

Trial evidence showed that Mazcuri, over a period of years, admitted and readmitted patients to PHP services in an indiscriminate manner; many of the patients suffered from Alzheimer's disease and dementia and were unable to participate in the therapy. In addition, trial documents showed that Riverside did not provide any of the services required under PHPs and falsified documents to make it appear that services were being administered.

Mazcuri, according to records presented at his trial, billed Medicare for more than $4.5 million in services that he claimed he personally administered. In addition, he signed documents that led to Riverside billing Medicare for $55 million in fraudulent services claims.

In addition to Mazcuri, 15 other individuals have been convicted in the scheme and sentenced to various prison terms.

— Image: Creative Commons/Nick Youngson