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Medicare fraud: $97 million for mentally ill patients to watch movies, play games

By   /   March 14, 2014  /   No Comments

By Eric Boehm | Watchdog.org

While taxpayers were picking up the tab for intensive, outpatient care for mentally ill patients, those patients were playing games and watching movies.

EXPENSIVE GAMES: Patients were supposed to be getting intensive treatments covered by Medicaid at a Houston facility. Instead, they were playing games and watching movies on the taxpayers’ dime.

It was part of a Medicare scam run by two Houston doctors who defrauded the system out of $97 million over five years.

A federal jury Thursday convicted physicians Mansour Sanjar, 81, and Cyrus Sajadi, 66, the owners of Spectrum Care P.A., along with several of their employees, for their roles in the Medicare scam. From 2006 through 2011, the doctors had been orchestrating a scheme in which they overbilled Medicaid for services that were not performed and, in many cases, which their patients were not eligible to receive.

Spectrum ran a partial hospitalization program for people with severe mental illnesses in need of intensive therapy and ongoing care.

According to the U.S. Justice Department, Sanjar and Sajadi billed Medicare for services when the beneficiaries were actually watching movies, coloring and playing games — activities not covered by Medicare.

An investigation by the FBI and the Inspector General of the U.S. Department of Health and Human Services found that many others patients at the facility were not covered under Medicare for any services.

Sanjar and Sajadi paid kickbacks to employees at other facilities and sometimes directly to patients.

The two physicians and five others convicted will be sentenced in September.

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Eric is a reporter for Watchdog.org and former bureau chief for Pennsylvania Independent. He lives in Minneapolis, Minnesota, where he enjoys great weather and low taxes while writing about state governments, pensions, labor issues and economic/civil liberty. Previously, he worked for more than three years in Harrisburg, Pennsylvania, covering Pennsylvania state politics and occasionally sneaking across the border to Delaware to buy six-packs of beer. He has also lived (in order of desirability) in Brussels, Belgium, Pennsburg, Pa., Fairfield, Conn., and Rochester, N.Y. His work has appeared in Reason Magazine, National Review Online, The Freeman Magazine, The Philadelphia Inquirer, The Washington Examiner and elsewhere. He received a bachelor's degree from Fairfield University in 2009, but he refuses to hang on his wall until his student loans are fully paid off sometime in the mid-2020s. When he steps away from the computer, he enjoys drinking craft beers in classy bars, cheering for an eclectic mix of favorite sports teams (mostly based in Philadelphia) and traveling to new places.

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