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Catch of the Week: Texas Hospital Exec Sentenced to 10 Years in Prison for Medicare Fraud

Posted  September 18, 2019

On Monday, a federal judge in Houston sentenced Starsky Bomer, the former CFO and COO of Atrium Medical Center and Pristine Healthcare, to ten years in prison for his role in a Medicare fraud scheme that bilked the government of $16m.  Bomer was convicted by a jury in October of last year.  His co-conspirator, Dr. Sohail R. Siddiqui, took a plea deal in 2017 and is serving five years in prison.

Bomer will do time for paying kickbacks to marketers and owners of group homes in exchange for referring patients to partial-hospital programs (PHP) at Bomer’s medical facilities.  PHPs provide intensive outpatient care to individuals suffering from severe mental illness.  But not everyone is eligible for admission to a PHP paid for by Medicare, and the evidence against Bomer showed that many of the admitted patients were not, in fact, in need of PHP treatment.  Even worse, some referred patients who were eligible did not receive the treatment they needed.  On top of prison time, Bomer was ordered to pay $6.3m in restitution.

Among other charges, Bomer was convicted of violating the Anti-Kickback Statute, which is designed to prevent money from corrupting medical decision-making.  Although there were no whistleblowers involved in Bomer’s case, whistleblowers play an important role in bringing healthcare fraud to light.  Hospital fraud and the provision of medically unnecessary services are particularly pernicious, harming  both taxpayers and patients.


Tagged in: Anti-Kickback and Stark, Catch of the Week, Criminal Proceedings, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medicare, Whistleblower Eligibility,