On Thursday, a Houston psychiatrist was convicted of participating in a $158 million Medicare fraud scheme, following a seven day federal jury trial. The charges against Sharon Iglehart, M.D., included conspiracy to commit health care fraud, one individual count of health care fraud and three counts of making false statements related to health care matters.
As reported by DOJ in a news release on Friday, the evidence presented at trial demonstrated that from 2006 until June 2012, Iglehart and others engaged in a scheme to defraud Medicare by submitting, through Riverside General Hospital (“Riverside”), approximately $158 million in false and fraudulent claims for Partial Hospitalization Program (“PHP”) services to Medicare. A PHP is a form of intensive out-patient treatment for severe mental illness.
The evidence at trial demonstrated that the beneficiaries for whom Riverside billed Medicare did not receive PHP services, and rarely saw a psychiatrist. Even when those beneficiaries did see a psychiatrist, they did not receive intensive psychiatric treatment. The government also presented evidence that Iglehart personally billed Medicare for individual psychotherapy and other treatment to patients that she never actually provided. This was exacerbated further by evidence that Iglehart falsified medical records of patients to make it appear as if she provided psychiatric treatment when, in fact, she did not.
Dr. Iglehart is the 13th individual to have been convicted of offenses based on their roles in the Riverside PHP scheme charged by the government. This includes former Riverside President, Earnest Gibson, III, who was sentenced in June to 45 years in prison. The details of his trial were outlined in a post on White-Collared on July 7, 2015. Both Gibson and his son, Earnest Gibson, IV, have appealed their sentences. Following his trial, Earnest Gibson, III, claimed that the government’s case was motivated by racism and a desire by others to obtain his hospital’s valuable real estate holdings in Houston’s Third Ward. Read More
After years of criticism that it failed to prosecute the individuals responsible for the financial crisis, the Department of Justice (“DOJ”) has announced changes to their internal guidelines to focus on the prosecution of individuals in corporate malfeasance cases.
At an event at New York University School of Law on Thursday, Deputy Attorney General Sally Quillian Yates discussed an internal memo addressing the handling of corporate cases she had just issued to all of the department’s prosecutors and civil litigators. The memo outlines six steps that Deputy Attorney General Yates stated were designed to “ensure that all department attorneys . . . are consistent in using our best efforts to hold individual wrongdoers accountable.”
The first step addresses the conditions precedent for crediting a corporation for cooperating. To receive credit, a corporation must now identify all individuals involved in the alleged misconduct – there will no longer be partial credit given for partial cooperation. To emphasize this point, corporate plea agreements will include provisions requiring ongoing cooperation, with failure to do so being considered a material breach triggering revocation of the agreement or stipulated penalties.
The second step is an exhortation to both criminal and civil attorneys of the department to focus on individuals from the outset, rather than trying to build a case against individuals only after a civil inquiry against the corporation has concluded – the latter being an often daunting task given the passage of time and the much higher burden of proof in criminal cases. To lend support to this second step, the third policy formalizes the lines of communication between civil and criminal attorneys to ensure both sides of the DOJ are discussing a given case from its inception.
The fourth and fifth steps appear to place additional restrictions on the resolution of corporate malfeasance cases in the face of parallel proceedings against individuals within the corporation. Read More
PHILADELPHIA, PA – Alexander M. Owens joins the Philadelphia, PA office of the law firm Pietragallo Gordon Alfano Bosick & Raspanti, LLP as an Associate in the Commercial Litigation Practice Group.
Prior to joining the firm, he was a law clerk to the Honorable David R. Strawbridge of the Eastern District of Pennsylvania. Mr. Owens interned with Michael Erdos of the Court of Common Pleas in Philadelphia. He was also an intern at the U.S. Environmental Protection Agency in Philadelphia where he was involved in the administrative, civil, and criminal enforcement of federal environmental laws.
Mr. Owens received his B.A., magna cum laude, from Boston University where he majored in International Relations. He earned his J.D., magna cum laude, from Temple University Beasley School of Law, graduating in the top 5% of his class. At Temple, he was an Executive Articles and Symposium Editor on the Temple Political & Civil Rights Law Review, a member of the Order of the Coif, and recipient of the Beasley Scholarship and Class of 1976 Scholarship. He received recognition for writing the best brief in his Legal Research & Writing class and for distinguished class participation in Employment Law, Trial Advocacy II, and Taxation. His law review article, Protecting Free Speech in the Digital Age: Does the FCC’s Net Neutrality Order Violate the First Amendment?, 23 Temp. Pol. & Civ. Rights L. Rev. 209 (2013), was published in the fall of 2013.
Mr. Owens is admitted to practice in Pennsylvania and New Jersey. Read More
Michael D. Lazzara and Alicia M. Passerin will be presenting Intellectual Property topics for growth companies at the University of Pittsburgh’s “Pitt Ventures 2nd Gear Program.” Read More
Pamela C. Brecht will present at the PBI program “Understanding the Basics of Fraud and Abuse in the Healthcare Industry.” She will be speaking on “The False Claims Act.” Read More
Articles In This Issue:
Spotlight: The Opening of the Richmond, VA Office
State and Federal Requirements for Employers’ Use of Criminal Background Checks
The United States Supreme Court Shifts the Balance of Power in Patent Litigation
U.S. Sentencing Commission Weighs Changes to White Collar Crime Sentencing Guidelines
Related Information:
summer_2015_newsletter.pdf Read More
Martin T. Durkin, Jr. will present a webinar for AHLA “Telemedicine: Making the Business Case for Telemedicine- Exploring Different Delivery Models and Their Regulatory Consequences” on How to Protect Against Fraud and Abuse While Promoting Telemedicine. Read More
Articles in this Issue:
1) Parting is Such A Sweet Sorrow: Pennsylvania Bids Farewell To The Gist of the Action Doctrine, and Further Opens the Door to Insurance Coverage for Construction Losses
2) Pennsylvania Supreme Court Rules That Home Improvement Consumer Protection Act Does Not Bar Contractors Form Raising A Claim For Money Due Based On Quantum Meruit
3) The Different Warranties Covering A Contractor’s Work
4) Employer Liability Exclusion Narrowed by Pennsylvania Supreme Court
5) Teamwork in Construction: A Recommendation Regarding Collaboration
Related Information:
summer_2015_edition_of_the_construction_legal_edge.pdf Read More
Marc S. Raspanti will speak at the 2015 Federal Bench-Bar Conference in Philadelphia, PA on the Federal Sentencing Trends Ten Years After United States v. Booker and Sentencing Advocacypanel. Read More
Christopher E. Ballod is moderating a panel entitled “Recent Developments in Coverage and Bad Faith” for the Professional Liability Attorney Network in New York. The Panel will include insurance industry professionald and other attorneys. Read More
