Final Defendant Convicted in $189 Million Health Care Fraud Scam
HOUSTON – With the plea of an 80-year-old Houston man, all 14 charged in the scam involving Continuum Healthcare and its various health centers have been convicted, announced U.S. Attorney Ryan K. Patrick.
Bobby Rouse admitted to conspiring to pay and receive kickbacks and to money laundering relating to the Medicare program today.
A total of 13 others have been convicted in relation to the scheme. A federal jury convicted Cheryl Waller, 73, of Houston, March 2, 2017, after a three-day trial on one count of conspiracy to pay and receive kickbacks and one count of receiving kickbacks. Those all convicted on the conspiracy count include Steven Houseworth, 46, James Bobino, 50, Ernestine Johnson, 60, Jackie Harris, 56, and Vermon Lacy III, 35, all of Houston; David Edson, 71, Palm Harbor, Florida; Jeffery Parsons, 60, Crockett; Aretha Johnson, 67, Wimberley; Inger Michelle Pace, 57, Missouri City; Ronald Turner, 59, Fresno; Deborah Davis, 56, Atlanta, Georgia; and Mary Browning, 71, Beasley. Edson and Parsons were also convicted of two counts of money laundering. Johnson also pleaded guilty to one count of money laundering, while Pace and Turner each further admitted to paying and receiving kickbacks.
Rouse, Houseworth, Edson and Parsons were part of the executive team for Continuum Healthcare LLC, which owned Westbury Community Hospital in Houston as well as community mental health centers in the Houston area known by their locations as Hornwood, Baytown and Missouri City.
During his plea today, Rouse admitted to participating in a kickback scheme to pay co-defendants to bring patients to Continuum. He admitted to causing Medicare to pay $18.8 million based on false and fraudulent claims.
Each location operated a partial hospitalization program (PHP). The PHP was supposed to be a treatment program for individuals with mental illness, intended to closely resemble a highly structured, short-term hospital inpatient program. However, while it was a distinct and organized intensive treatment program, it offered less than 24-hour daily care.
In 2010, Continuum opened Westbury Community Hospital with Hornwood and Baytown becoming outpatient centers and continuing to operate their existing PHPs under the Westbury name. Westbury also opened a PHP.
Rouse, Houseworth, Edson and Parsons were responsible for the day-to-day operation of Continuum/Westbury and were involved in the implementation of the various kickback programs. Numerous people were referred for treatment in exchange for payment. However, the vast majority did not qualify for PHP services, because they were not experiencing an acute psychotic episode or were actually suffering from mental retardation, dementia or Alzheimer’s.
Aretha Johnson, Pace, Bobino, Waller, Browning and Davis each owned personal care homes in Houston, while Ernestine Johnson, Harris, Lacy and Turner were marketers for Continuum. Each admitted receiving payment to refer the patients, receiving amounts ranging from $130,000 t0 $2.6 million each.
In total, Continuum billed Medicare approximately $189 million in total for fraudulent PHP services and Medicaid paid approximately $66 million on those clams.
U.S. District Judge Gray Miller accepted the plea and has set sentencing for Jan. 23, 2020, at which time Rouse faces up to 10 years in prison and a possible $250,000 maximum fine. Rouse was permitted to remain on bond pending that hearing.
The FBI, Department of Health and Human Services - Office of the Inspector General, Texas Attorney General's Medicaid Fraud Control Unit and IRS - Criminal Investigation participated in the joint investigation. Assistant U.S. Attorneys Tina Ansari and Special Assistant U.S. Attorney Justin Blan are prosecuting the case.