A Houston, Texas-area hospital administrator was sentenced today for his role in a $16 million Medicare fraud scheme involving partial hospitalization programs.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan Patrick of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Dallas Region, and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.
Starsky Bomer, 46, of Houston, Texas, was sentenced by U.S. District Judge Vanessa Gilmore of the Southern District of Texas to 10 years in prison for his role in the scheme, and ordered the defendant to pay $6,277,575.77 in restitution and to forfeit $158,260. On Oct. 5, 2018, following a five-day trial before Judge Gilmore, Bomer was convicted of one count of conspiracy to receive health care kickbacks, two counts of violating the Anti-Kickback Statute, and one count of conspiracy to commit healthcare fraud from a November 2017 superseding indictment.
According to evidence presented at trial, from 2011 until February 2013, Bomer and his co-conspirators engaged in a scheme to defraud Medicare by submitting to Medicare, through Atrium Medical Center (Atrium) and Pristine Healthcare (Pristine), approximately $16 million in false and fraudulent claims for partial hospitalization program (PHP) services. A PHP is a form of intensive outpatient treatment for severe mental illness.
The evidence presented at trial showed that Bomer, the hospitals’ chief financial officer and chief operating officer, orchestrated a scheme by which he and others paid illegal bribes and kickbacks to group home owners and patient recruiters in exchange for sending Medicare patients to Atrium and Pristine’s PHPs. Bomer disguised bribes and kickbacks as salary payments and transportation payments to group home owners in exchange for patient referrals. In addition, evidence presented at trial showed that Bomer knew that many of the patients admitted to Atrium and Pristine’s PHPs did not qualify for and were never provided legitimate partial hospital services.
This case was investigated by the FBI, HHS-OIG and the Texas Attorney General’s MFCU. Assistant Chief Aleza Remis and Trial Attorneys Jason Knutson and Gerald M. Moody, Jr. of the Criminal Division’s Fraud Section prosecuted the case.
The Medicare Fraud Strike Force is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
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Author: September 16, 2019