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Wed May 24, 2017, 04:22 AM

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


Department of Justice
Office of Public Affairs

Tuesday, May 23, 2017

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

After a five-day trial, Riaz Mazcuri, 65, of Harris County, Texas, was convicted of one count of conspiracy to commit health care fraud and five counts of health care fraud.  Sentencing has been scheduled for Oct. 10, 2017, before U.S. District Judge Vanessa D. Gilmore of the Southern District of Texas, who presided over the trial. 

According to evidence presented at trial, from 2006 until February 2012, Mazcuri and others engaged in a scheme to defraud Medicare by submitting to Medicare, through Riverside General Hospital (Riverside), approximately $158 million in false and fraudulent claims for partial hospitalization program (PHP) services.  A PHP is a form of intensive outpatient treatment for severe mental illness. 

The evidence presented at trial showed that Mazcuri participated in a scheme by which Riverside paid bribes and kickbacks to group home owners and nursing home employees in exchange for sending Medicare patients to Riverside’s PHPs.  Mazcuri indiscriminately admitted and readmitted these patients into these intensive psychiatric programs – often for years on end – many of whom suffered from severe Alzheimer’s or dementia and were unable to participate in the treatment purportedly provided at the PHPs, and who therefore did not qualify for the services, the evidence showed. 

In addition, evidence presented at trial showed that Mazcuri rarely saw patients and that he visited the PHPs briefly every week or so to sign documents and briefly see patients.  Additionally, Mazcuri falsified medical records and signed false documents purporting to show that patients admitted to the PHPs qualified and required the intensive psychiatric services, the evidence showed.  Evidence also showed that Riverside did not actually provide the intensive, psychiatric treatment that a PHP is supposed to provide and falsified documentation to make it appear to Medicare that intensive treatment was being provided to qualifying patients.  

Evidence at trial demonstrated that Mazcuri personally billed Medicare for over $4.5 million for psychiatric treatment he purportedly provided to Riverside’s PHP patients.  Mazcuri’s signature on patient documents enabled Riverside to bill Medicare for $55 million of the total $158 million that Riverside billed Medicare for fraudulent psychiatric services, the evidence showed.

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Reply Houston-Area Psychiatrist Convicted of Health Care Fraud for Role in $158 M Medicare Fraud Scheme (Original post)
nitpicker May 2017 OP
Soxfan58 May 2017 #1

Response to nitpicker (Original post)

Wed May 24, 2017, 05:12 AM

1. We have a guy in Maine

Who stole 2 million from the state medicaid fund as a pharmacist. You know what they did to him...... Made him the republican speaker of the house.

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