Former medical director Roger Rousseau guilty of $63 million Medicare fraud
Rousseau routinely signed what he knew to be fabricated and altered medical records.
The former medical director of a now-defunct healthcare provider in Miami, along with three therapists formerly employed there, have been convicted for their roles in fraudulently billing Medicare and Florida Medicaid for more than $63 million, according to the Department of Justice.
Medicare and Medicaid paid about $28 million on those claims, authorities said.
Roger Rousseau, 73, of Miami, is the former medical director of Health Care Solutions Network, a now-defunct partial hospitalization program that purported to give intensive treatment for mental illness.
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From 2004 through 2011, Health Care Solutions Network billed Medicare and Medicaid for mental health services that were not medically necessary or never provided, and paid kickbacks to assisted living facility owners and operators in Miami who, in exchange, referred beneficiaries to the program, according to evidence presented at trial.
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, according to evidence presented at court.
A federal jury in Miami on August 24 found Rousseau and therapists Doris Crabtree, 62, of Miami; Angela Salafia, 68, of Miami Beach; and Liliana Marks, 48, of Homestead, Florida guilty of conspiracy to commit healthcare fraud.
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In addition, Rousseau was convicted of two counts of healthcare fraud.
Sentencing is scheduled for Nov. 6 in U.S. District Court, Southern District of Florida.
In November 2014, following a jury trial, co-defendants in the case, Blanca Ruiz and Alina Fonts, were convicted of conspiracy to commit healthcare fraud, and Fonts also was convicted of healthcare fraud. In February 2015, both Ruiz and Fonts were sentenced to serve six years in prison, according to the Department of Justice.
Twitter: @SusanMorseHFN
