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More Kickbacks, More Prosecutions, More Prison Time

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at January 14, 2015

The two physician owners of a Houston-area mental health clinic were sentenced today to 148 months and 120 months respectively for their roles in a $97 million Medicare fraud scheme. A group home owner who sent residents to the clinic in exchange for kickbacks was also sentenced to 54 months in prison for her role. In addition to the prison sentences, U.S. District Judge Vanessa D. Gilmore of the Southern District of Texas ordered Sanjar and Sajadi to pay $8,058,612.39 in restitution, and Nunn to pay $1,885,667.41 in restitution.

Sanjar and Sajadi owned Spectrum, which purportedly provided partial hospitalization program (PHP) services. Evidence presented at trial showed that Sanjar and Sajadi signed admission documents and progress notes certifying that patients qualified for PHP services, when in fact, the patients did not qualify for or need PHP services. Sanjar and Sajadi also billed Medicare for PHP services when the beneficiaries were actually watching movies, coloring and playing games, which are not activities covered by Medicare.

Sanjar and Sajadi paid kickbacks to group care home operators and patient recruiters in exchange for delivering ineligible Medicare beneficiaries to Spectrum. In some cases, the patients received a portion of those kickbacks.

According to evidence presented at trial, Spectrum billed Medicare for approximately $97 million in services that were not medically necessary and, in some cases, not provided.

http://www.justice.gov/opa/pr/physician-owners-mental-health-clinic-sentenced-97-million-medicare-fraud-scheme

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