Friday, December 16, 2011

Owners of Houston Mental Health Company and Assisted Living Facility Indicted for Alleged Roles in $90 Million Medicare Fraud Scheme


Source- http://www.justice.gov/opa/pr/2011/December/11-crm-1639.html

WASHINGTON – Two owners of a Houston mental health care company, Spectrum Care P.A., and the owner of a Houston assisted living facility were arrested today on charges related to their alleged participation in a $90 million Medicare fraud scheme, announced the Department of Justice, the Department of Health and Human Services (HHS) and the FBI.

Mansour Sanjar, 78, Cyrus Sajadi, 64, and Chandra Nunn, 33, all of Houston, were arrested today in Houston and are expected to make their initial appearances in federal court today and tomorrow. An indictment filed in the Southern District of Texas charges Sanjar, Sajadi and Nunn with conspiracy to commit health care fraud and conspiracy to pay and receive illegal health care kickbacks.

“These defendants allegedly participated in a scheme to cheat the Medicare program out of more than $90 million,” said Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division. “The indictment alleges that Spectrum billed Medicare for mental health services when patients were actually watching movies, playing bingo or engaging in other activities. Our efforts over the past three years to combat Medicare fraud have been unprecedented, and today’s arrests are another example.”

“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 the indictment, Sanjar and Sajadi orchestrated and executed a scheme to defraud Medicare beginning in 2006 and continuing until their arrest today. Sanjar and Sajadi owned Spectrum Care P.A., a Houston mental health company that purportedly provided partial hospitalization programs (PHP). A PHP is a form of intensive outpatient treatment for severe mental illness. Sanjar and Sajadi allegedly submitted false and fraudulent claims to Medicare through Spectrum.

According to the indictment, Nunn owned a Houston assisted living facility. The indictment alleges that Sanjar and Sajadi paid kickbacks to Nunn and other owners and operators of assisted living facilities and to patient brokers in exchange for delivering ineligible Medicare beneficiaries to Spectrum. In some cases, the patients received a portion of those kickbacks.

Sanjar and Sajadi allegedly billed Medicare for treatments purportedly provided to these recruited patients. According to the indictment, the treatments were medically unnecessary or never provided at all. The indictment alleges that Spectrum billed Medicare for more than $90 million in medically unnecessary services.




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