Four executives were sentenced to prison after pleading guilty to their roles in a $189 million healthcare fraud scheme, the Department of Justice announced.
The four — Bobby Rouse, Steven Houseworth, Jeffery Parsons, and David Edson — were the final defendants involved in the scheme involving Houston-area Continuum Healthcare to be sentenced. A total of 14 people have now been fully prosecuted, DOJ said.
Continuum owned Westbury Community Hospital in Houston as well as other community mental health centers in the area, known by their locations, including Hornwood, Baytown, and Missouri City.
Each location operated a partial hospitalization program (PHP), which is designed to provide round-the-clock inpatient care on a short-term basis for patients experiencing acute psychosis, dementia, or Alzheimer’s. However, it offered less than 24-hour daily care, according to DOJ.
The four who were recently sentenced were responsible for day-to-day operations of the company, and implemented kickback programs, in which patients were referred for treatment in exchange for payment, according to DOJ.
However, the majority of patients didn’t qualify for PHP services because they weren’t having an acute psychotic episode or suffering from severe mental impairment, dementia, or Alzheimer’s, DOJ said.
Continuum allegedly billed $189 million in fraudulent PHP services, for which Medicaid ultimately paid about $66 million.
All 14 defendants were initially convicted in 2019. During Rouse’s plea hearing at the time, he admitted to billing Medicare for $18.8 million based on false claims and paying his co-defendants to bring patients to Continuum for treatment.
Many of the 14 convicted confessed to receiving money in return for patient referrals, with amounts ranging from $130,000 t0 $2.6 million.
Rouse was sentenced to 10 years in prison, Edson to to 4 years, and Parsons and Houseworth both received 30-month sentences.