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Three Health care Business o owners Arrested in $90 million m medicare Fraud scheme m s
By terri langforD angfor (Houston Chronicle) The owners of a Houston mental health program were arrested on Wednesday, December 14, charged with trying to bilk Medicare out of $90 million for treatments that amounted to little more than patients “watching movies, playing bingo or engaging in other activities,” federal authorities contend. Mansour Sanjar, 78, and Cyrus Sajadi, 64, both physician owners of Spectrum Care in West Houston were charged in the alleged phony treatment scheme, which involved kickbacks to the owner of an assisted living facility in exchange for finding and funneling patients to the clinic. Chandra Nunn, 33, the owner of the home, also was arrested. All three are charged with conspiracy to commit health care fraud and conspiracy to pay and receive illegal health care kickbacks. Since 2006, Center and Sajadi had been submitting bills to Medicare for supposed treatment at their “partial hospitalization program,” known as a PHP. The arrests come just two months after a Houston Chronicle investigation uncovered hundreds of millions in Medicare dollars spent to shepherd mentally fragile Texans by ambulance to mental health clinics and PHPs where patients claimed they watched TV and ate junk food. According to the indictment, the Spectrum Care owners submitted $90.4 million in claims starting in 2006 even though the PHP services “were not medically necessary, and in some cases, never provided.” Nunn’s role was that of a patient broker, or what clinics call, a “marketer.” Sanjar is accused of paying Nunn with a $10,000 check in September 2010 to refer patients their way. The indictment accused all three defendants of paying Medicare beneficiaries cash and cigarettes if they came to Spectrum. Attempts to reach the three were unsuccessful. Texas Medical Board records show the agency disciplined Sajadi last February for failing to keep good records on a patient. The doctor did not admit to or deny the findings but agreed to complete in one year, eight hours of continuing education on medical recordkeeping. In 2005, Sajadi was ordered by the board to complete nine hours of ethics courses, pay a $1,000 fine for violating a state law that requires a doctor who denies medical records to explain why the information was not provided. The board also disciplined Sanjar in 2003 for overprescribing narcotics to a patient.
The federal charges filed Wednesday did not list the name of Nunn’s facility. Public records show she is the registered agent for an operation called Love & Caring Homes Inc., that was incorporated on June 28, 2010. It is unclear whether the home was licensed by the state. Spectrum is one of nearly two dozen community mental health centers and PHPs in Harris County
that have collected millions in Medicare dollars, but require no license to operate in Texas, the Chronicle’s investigation in October found. The patients are mostly poor, some near homeless, who live in personal care homes, assisted living facilities - like that owned by Nunn - or apartments arranged by caretakers and caseworkers. The paper’s investigation also documented that the burgeoning business of mental health care in Houston is further fueled by the local private ambulance industry, which ferries patients to therapy and also bills Medicare. Nearly $500 million was paid by Medicare to private EMS operators in Harris County over a sixyear period, records show. By the federal government’s own rules, many of these EMS transports are not medically necessary and should not even qualify for federal dollars. Wednesday’s arrests were part of a larger operation involving several federal and Texas agencies
including the Federal Bureau of Investigation, U.S. Health and Human Services’ Office of Inspector General, the Texas Attorney General’s Medicaid Fraud Unit and the U.S. Attorney’s Office for the Southern District of Texas. “This case is another excellent example of the partnership and cooperation between the U.S. Attorney’s Office, the Department of Justice and our investigating agencies,” said U.S. Attorney Kenneth Magidson of the Southern District of Texas. “We will continue to work closely with each other to ensure those who engage in such fraudulent health care practices are brought to justice.” According to Medicare data obtained by the Chronicle, Spectrum Care received more than $1 million from Medicare in 2010. The indictment filed indicates Spectrum Care has been paid more than $6.5 million since 2006. Private ambulance data obtained by the Chronicle also shows private ambulances making trips to Spectrum collected more than $19 million in Medicare money in recent years. When asked about whether ambulance companies would be charged in relation to Spectrum’s scheme, U.S. Department of Justice spokeswoman Alisa Finelli would say only that “our investigation into Spectrum is ongoing.” A report released Wednesday, based on 2011 Department of Justice data, shows Houston is second in the nation for Medicare fraud prosecutions. When grouped with Miami, these two federal court districts accounted for more than one of every five health care fraud prosecutions. The report was the work of the Syracuse University’s Transactional Records Access Clearing Clearinghouse.
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BollywoodSho EXPLOSION 200ws4U Brings 9 to Houston HOUSTON: Sonu dhi Chauhan and Nigam, SuniHard to make a stunning Kaur are set the Explosions eventappearance in Bollywood Shows organized by 4 by Moid Khan. The U conducted event be held at the Reliant is set to Arena on August 7, 2009.
ers to Houston thus
making Houstonian s dreams organizing “Explosion come true, by 2009” Concert. “Explosion 2009 will Houston residents be giving a night non-stop session long of rock rocking Bollywood melodies, promising one of the most memorable musical treats like never witnessed before. For tickets log on to www.bollywood oodshows4u.com or call 281-2354711.
Moid Khan informed that Houston residents have been waiting for a long time to see the live performance of Sonu Nigam. Bolly Bollywoodshows4u is bringing the performperform
Houston. The Foundation could not have chosen a to raise awareness better topic among IndoB P Americans in Houston K about its HOUSTON: If there’s one recent Indian studies programs. movie that has polarized opinions the discussion of the Prior to film, Parul about India, it Fernandes is lionaire. The movieSlumdog Mil- explained and Krishna Vavilala ements of entertainmhas all the el- is currentlythat the Foundation ent designed conducting Hindi to glue you to your seat – shock, Level I and Level II courses awe, amusemen as well as t, love and inspiration disgust, true Jainism classes on Hinduism, and the Anthropolo have seen movie . Some people India. gy of The each time moved several times, received Foundation has also to There are a few tears and joy. governmensupport from Indian others, however, t’s Ministry of who could not get past the slum seas Indians to fund a OverChair for kid’s jump into Indian studies at the UH. blinding of a child. cesspool or the An 11-minute clip of Slumdog More than 120 people with prob- Millionaire, edited by Anil Kuably 200 opinions about the movie mar, was screened to stimulate assembled at a the discussion. The town clip included held at India House hall meeting scenes depicting negative last Sunday afternoon. aspects of India such as religious The town hall mony, child prostitution disharmeeting was or or, and ganized by the Foundation for lice brutality. These scenes poIndia Studies at were the University of followed by uplifting scenes in
Ambassador Ambassador MeeraMeera Shankar Shankar visits Houston Visits Page 11
Houston Page 11
Central Texas Temple Grows
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NRI nvestors LoseChilled Money IACCGH to Maytas Waterm Helps elonto Proper ties in Soup Hire India Page Page 5 26
NRI Investors Lose Money to Maytas Properties in India Page 21 Indo-American
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