by | last updated on January 21, 2016
According to a release from the Department of Justice, Miami psychiatrist Roger Rousseau is facing allegations of Medicare fraud after he was arrested in Miami in mid-July. He and six other therapists were arrested for allegedly conspiring to commit $63.7 million in fraudulent actions.Rousseau was the medical director of Health Care Solutions Network (HCSN) which was owned by Armando Gonzalez, who was recently sentenced to 14 years in prison for Medicare fraud charges at clinics in South Florida and North Carolina. HCSN allegedly received about $28 million for services never performed or that were unnecessary.Rousseau allegedly signed off on medical records while failing to review the documents – which he allegedly knew were altered – and in most cases never saw the patient. The prosecutors allege that therapists fabricated records to justify claims made for partial hospitalization programs. Prosecutors argue that these treatments were unnecessary and that the services were never provided to the patients.

Unnecessary treatments are one of the main ways clinics may be held liable for Medicare fraud. Having detailed medical records and a solid knowledge of patient history is one of the best methods a medical professional can practice to ensure he or she is able to fight charges of Medicare fraud, should they arise.

HCSN also allegedly paid kickbacks to operators of assisted living facilities for referring patients.

Uncovering the Full Scope of Medicare Fraud

In this particular case there were several types of Medicare fraud that federal investigators are now looking at as part of the criminal investigation.

The FBI and Health and Human Services are looking at:

  • unnecessary services, where Medicare was billed for services or treatment that was unnecessary for a patient’s care;
  • services not rendered, where Medicare was billed for services, treatment or items that the patient never received;
  • kickbacks, where patient recruiters or operators for assisted living facilities received compensation for referring patients to certain clinics or facilities for treatment; and
  • medical record fraud, where professionals signed off on altered or fabricated medical records created to fraudulently charge Medicare.

Our Fort Lauderdale Attorneys Fight against Medicare Fraud

Attorney Robert Malove has seen many cases like this before, “Tremendous financial resources are required to mount a worthy defense to a charge of Medicare fraud. Statistically, the odds of being acquitted are less than 10 percent nationwide. To make matters worse, the sentences that are being imposed by judges after someone is convicted of committing Medicare fraud are astronomical!”

Mr. Malove says, “Oftentimes, defendants are much better off to cut their losses and negotiate a resolution to limit exposure to serving double digit years behind bars. It is critical that anyone who is being investigated or who has been charged with Medicare fraud seek out the best possible legal advice from an attorney who is well-versed in these types of cases.”

Fort Lauderdale Medicare fraud attorney Robert Malove is here to help healthcare professionals fight charges of Medicare fraud. If your practice or business is in jeopardy because of accusations of fraudulent activity, contact our office at 954-861-0384 to schedule a consultation regarding your rights.