From: bulldog23x@gmail.com   
      
   Medical Director and Three Therapists Convicted in $63 Million Health Care   
   Fraud Scheme    
      
      
   25 Aug 2015 11:09        Written by Press Release        Category: Federal and   
   International    
   Washington, DC--(ENEWSPF)--August 25, 2015. A federal jury in Miami late   
   yesterday convicted the former medical director of, and three therapists   
   employed by, a now-defunct health care provider of conspiracy to commit health   
   care fraud and related    
   charges for their roles in a scheme to fraudulently bill Medicare and Florida   
   Medicaid more than $63 million.    
      
      
        
   Assistant Attorney General Leslie R. Caldwell of the Justice Department's   
   Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of   
   Florida, Special Agent in Charge George L. Piro of the FBI's Miami Field   
   Office and Special Agent in    
   Charge Shimon Richmond of the U.S. Department of Health and Human   
   Services-Office of Inspector General's (HHS-OIG) Miami Regional Office made   
   the announcement.    
      
   Roger Rousseau, 73, of Miami; Doris Crabtree, 62, of Miami; Angela Salafia,   
   68, of Miami Beach, Florida; and Liliana Marks, 48, of Homestead, Florida,   
   were found guilty of conspiracy to commit health care fraud.  In addition,   
   Rousseau was convicted of    
   two counts of health care fraud.  Sentencing is scheduled for Nov. 6, 2015,   
   before U.S. District Judge Robert N. Scola Jr. of the Southern District of   
   Florida.    
      
   Rousseau was the former medical director of Health Care Solutions Network Inc.   
   (HCSN), a now-defunct partial hospitalization program (PHP) that purported to   
   provide intensive treatment for mental illness.  Crabtree, Salafia and Marks   
   were therapists who    
   worked for HCSN.    
      
   According to the evidence presented at trial, from approximately 2004 through   
   2011, HCSN billed Medicare and Medicaid for mental health services that were   
   not medically necessary or never provided, and that HCSN paid kickbacks to   
   assisted living facility    
   owners and operators in Miami who, in exchange, referred beneficiaries to   
   HCSN.    
      
   The trial evidence showed that Rousseau routinely signed what he knew to be   
   fabricated and altered medical records without reviewing the substance of the   
   records and, in most instances, without ever meeting with the patients.  The   
   evidence at trial also    
   demonstrated that Crabtree, Salafia and Marks fabricated medical records to   
   support HCSN's false and fraudulent claims for reimbursement for PHP services.    
      
   In total, HCSN submitted approximately $63.7 million in false and fraudulent   
   claims to Medicare and Medicaid.  Medicare and Medicaid paid approximately $28   
   million on those claims.    
      
   In November 2014, following a jury trial, co-defendants Blanca Ruiz and Alina   
   Fonts were convicted of conspiracy to commit health care fraud, and Fonts also   
   was convicted of health care fraud.  In February 2015, both Ruiz and Fonts   
   were sentenced to    
   serve six years in prison.    
      
   The case was investigated by the FBI and HHS-OIG, and was brought as part of   
   the Medicare Fraud Strike Force, under the supervision of the Criminal   
   Division's Fraud Section and the U.S. Attorney's Office of the Southern   
   District of Florida.  The case was    
   prosecuted by Trial Attorneys Allan J. Medina, Lisa H. Miller and Bryan D.   
   Fields of the Criminal Division's Fraud Section.    
      
   Since its inception in March 2007, the Medicare Fraud Strike Force, now   
   operating in nine cities across the country, has charged over 2,300 defendants   
   who collectively have billed the Medicare program for over $7 billion.  In   
   addition, HHS's Centers for    
   Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking   
   steps to increase accountability and decrease the presence of fraudulent   
   providers.    
      
   To learn more about the Health Care Fraud Prevention and Enforcement Action   
   Team (HEAT), go to: www.stopmedicarefraud.gov.    
      
   Source: www.justice.gov    
      
        
      
      
   http://www.enewspf.com/latest-news/law-and-order/federal-and-int   
   rnational/63772-medical-director-and-three-therapists-convicted-   
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