Psychiatrist convicted in $158 million Medicare scheme involving SNF residents

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A Texas psychiatrist was convicted on Tuesday for his role in a $158 million Medicare fraud scheme that involved paying kickbacks to nursing home employees in exchange for patient referrals.

Riaz Mazcuri, M.D., along with other healthcare providers, engaged in a scheme between 2006 and 2012 to admit patients into an intensive psychiatric program known as a partial hospitalization program, or PHP, through Riverside General Hospital in Houston.

The set-up included Mazcuri and others paying kickbacks and bribes to nursing home employees, as well as home healthcare owners, in exchange for referring Medicare beneficiaries to the PHPs. The beneficiaries were “indiscriminately admitted,” the Department of Justice said in a press release, and many did not quality for PHP services since they had Alzheimer's disease or dementia.

Mazcuri also reportedly rarely visited the PHP patients, and falsified medical documents to show that beneficiaries admitted to the programs were qualified for the treatment. Those treatments were not actually provided to patients, the DOJ said.

Mazcuri personally billed Medicare for more than $4.5 million in psychiatric treatments, and signed off on documents accounting for $55 million of the $158 million billed by Riverside throughout the scheme.

Fifteen others, including Riverside's former president, physicians and a group home owner, have also been convicted in the scheme. Mazcuri was convicted of one count of conspiracy to commit healthcare fraud and five counts of healthcare fraud. His sentencing has been scheduled for Oct. 10, 2017.