Policy: Entitlements

Texas doctor made millions in Medicare scheme, gets 52 months in slammer

Watchdog Blog,Texas,Medicare and Medicaid,Entitlements,Inspectors General,Waste and Fraud,Ethan Barton

A Texas physician was sentenced to 52 months in federal prison and ordered to pay nearly $7 million in restitution after pleading guilty to conspiracy to commit health care fraud, according to the Justice Department.

Donald Gibson II, 57, of Sugar Land, Texas, pleaded guilty to the conspiracy charge on April 1. Gibson paid patients to show up for medically unnecessary diagnostic tests and physical therapy, then billed Medicare and Medicaid for the services.

His scheme caused more than $19.4 million in false medical claims to Medicare and Texas Medicaid from January 2007 to January 2012, $8.5 million of which went to Gibson's bank account.

“Gibson worked in conjunction with the owners and operators of medical clinics and diagnostic testing centers in the Houston area,” the press release said. “As part of the scheme, Medicare patients were paid to show up at the clinics for testing.”

Gibson's co-defendant, Sunday Joseph Edem, 53, of Richmond, Texas, has a sentencing hearing scheduled on Nov. 18, and also pleaded guilty to the same charge on Feb. 25, according to an April press release.

“Edem operated medical clinics under the names of other individuals to conceal his financial interest in the business,” the earlier release stated. “Edem and Gibson conspired with one another to cause the submission of false claims to the Medicare and Medicaid programs and shared in the proceeds.”

The restitution ordered by U.S. District Judge Lynn Hughes will have more than $3 million deducted and returned to Medicare because of a $2.62 million seizure of Gibson’s assets and a $505,455 freeze on Medicare payments to the physician.

The case stemmed from a joint investigation from multiple federal and state agencies.

Read the report here.

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