May 24, 2017

Houston-Area Psychiatrist Convicted of Health Care Fraud for Role in $158M Medicare Fraud Scheme

By the C|C Whistleblower Lawyer Team

A jury convicted Texas psychiatrist Riaz Mazcuri of conspiracy to commit health care fraud and five counts of health care fraud. He is the latest to be convicted in a $158 million dollar scheme to defraud Medicare by submitting false claims for partial hospitalization program (PHP) services, an intensive outpatient treatment for mental illness. Thus far, 15 others have been convicted for their part in the scheme.

According to the government, the claims, which were submitted through Riverside General Hospital, were false because the hospital “paid bribes and kickbacks to group home owners and nursing home employees in exchange for sending Medicare patients to Riverside’s PHPs.” The government presented evidence showing Mazcuri admitted and readmitted patients, sometimes for years, when the patients were not even able to participate in the treatment supposedly being provided. He also rarely saw patients and did not provide the required intensive psychiatric treatment, instead falsifying medical records to defraud Medicare into making the payments. Mazcuri’s signature on patient records allowed Riverside to bill the government for $55 million of the total $158 million in fraudulent claims.

Mazcuri’s sentencing is scheduled for October 2017.

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