This week, a federal jury in Miami convicted three therapists and a medical director of healthcare fraud in a scheme to bill Medicare and Florida Medicaid more than $63 million, of which, approximately $28 million was reimbursed.
Roger Rousseau, Doris Crabtree, Angela Salafia, and Liliana Marks were found guilty and will be sentenced on November 6.
Rousseau was the former medical director of Health Care Solutions Network Inc. (HCSN), a now-defunct partial hospitalization program that purported to provide intensive treatment for mental illness. Crabtree, Salafia and Marks were therapists who worked for HCSN.
The treatment center billed Medicare and Medicaid for mental health services that were not medically necessary or never provided, and HCSN also paid kickbacks to assisted living facility owners and operators in Miami who provided patient referrals.
The trial evidence showed that Rousseau routinely signed what he knew to be fabricated and altered medical records and, in most instances, never met the patients. The evidence also showed that Crabtree, Salafia and Marks fabricated medical records to support HCSN’s fraudulent claims for reimbursement.
In November 2014, following a jury trial, co-defendants Blanca Ruiz and Alina Fonts were convicted of fraud and were sentenced to serve six years in prison.
The case was brought to trial as part of the Medicare Fraud Strike Force, which has now charged more than 2,300 defendants.