Tag Archives: Medicare Fraud

Following up on Congresswoman Sheila Jackson-Lee and Medicare Fraud at Houston’s Riverside General Hospital

By Gary P Jackson

A couple of weeks ago I wrote about the massive Medicare scandal revolving around Houston’s Riverside General Hospital and Congresswoman Sheila Jackson-Lee, who has deep, decades long ties to the hospital.

One of the things I really love about writing is sometimes I have the chance to talk with interesting, brave, and honorable men and women. People who do the right thing when doing nothing would be a hell of a lot easier. LaCheryl E. Whitlow is one of those people.

As a result of the story, I’ve had a running conversation with LaCheryl about the total mess in Houston, as well as the corruption. She’s been blogging continuously about the situation, trying to set the record straight as well as offering up sincere, heartfelt commentary.

LaCheryl is a long time Jackson-Lee supporter, and you can feel the hurt and pain in her writing. You can also see LaCheryl is one of those extraordinary people who refuse to sit back while surrounded by corruption, when she can speak out instead. Her blog Truth Hurts Like Hell is a must read for those looking to get the latest on the scandals, and goings on at Riverside General.

As many of our readers are Palin supporters, it shouldn’t be hard to understand why I find myself admiring LaCheryl greatly. Reform, ethics, corruption busting, is why we admire Sarah Palin so much. Anyone who stands up and speaks out, when it would be much simple to sit down and shut up [safer too] should be admired and thanked.

I only know LaCheryl through our interaction and her blog, but I admire her courage greatly. Like any reform minded person, she’s being attacked mercilessly. I’ve had several who have viciously attacked her in our comments section. [Though I’ve not given them the satisfaction of seeing their hate in print, I’ve saved them]LaCheryl tells me she’s been getting steady hate from those angry she’s doing the right thing.

I want to encourage our readers to go back and re-read the lengthy story on the massive Medicare fraud the management of Riverside General has been involved in, as well as the various comments LaCheryl left along with videos.

I also encourage everyone, Texans especially, to take a look at LaCheryl’s blog to learn more about the difficult situation the workers at the Hospital now face because of the incredibly corrupt management.

The latest from LaCheryl IF THE ADMINISTRATORS OF RIVERSIDE GENERAL HOSPITAL WERE WHITE is a quite eye opening:

IF THE ADMINISTRATORS OF RIVERSIDE GENERAL HOSPITAL WERE WHITE

…would any of this be a factor?

With all that has come out about Riverside General Hospital in the local paper and the media I often wonder had this hospital administration been all white would the unfolding issues that have been exposed in the public taken place in the same manner?

I wonder if the predominately black employees that have witnessed the abuse, neglect, and corruption that has taken place within the walls of that historically black institution been so passive at coming fourth with the truth or be as closed mouth had the administrators been white?

When payday rolls around and they have diligently worked hard, kept their work areas neat and clean, and respecting of management, and so forth and a white supervisor tells them, “Sorry we don’t have your check today because there is aglitchin the system, contact the Human resource dept.” Would they believe that had it come from a white person as the truth?

When they contact the Human Resources director and inquire about their pay and the H.R director (being white also in this case) told them to wait until the following week for their check or I’m not concerned if you got your check or not because I got mine, etc. Would the employees of Riverside General Hospital take that from a white H.R director?

What about the patient abuse that has taken place there? The shredding of files and other “cover-ups…IF THE ADMINISTRATORS OF RIVERSIDE GENERAL HOSPITAL WERE WHITE would the black employees there still be as nonchalant about speaking out against them?

If the director of nursing and the charge nurse on Riverside general hospital were white and talked to people in the horrible and disrespectful way they are KNOWN for would it be different…IF THE ADMINISTRATORS OF RIVERSIDE GENERAL HOSPITAL WERE WHITE?

If the CEO raced in a room and told people that “they could have the scraps” in the conference room, and people cleared the hall when she stepped downstairs, or bowed their heads and closed their mouths when she entered a room…would they do it is she were white? If the president of that hospital was accused of the EXACT same thing he is accused of now would the employees believe it more if he had blond hair, blue eyes, and white?

Much more here.

LaCheryl is black, as are most of the employees and management at Riverside Hospital. This took real courage for her to say what she’s saying. Her post speaks to the REAL problem we face when it comes to corruption.

It’s not just blacks who tolerate corrupt blacks in the name of “solidarity” it’s many groups. We’ve seen Republicans excuse corruption among Republicans. I know, I got attacked for exposing Rick Perry and others last year. We see democrats excuse all corruption in the name of politics as well. This sort of behavior breaks all social, racial, and political boundaries.

Sarah Palin was attacked by fellow Republicans after she took down much of the corrupt Republican Party [including the Attorney General and the state GOP Chairman]in Alaska. The GOP hates her to this day for it. From what I’m already seeing, LaCheryl has faced much of the same, from her peers.

Peer pressure is a strong motivator. It can motive one to do great things, or cause great evils. It can also cause many a good person to sit by as evil occurs, rather than speak up. That’s why we admire people who will stand up, no matter what the personal cost to themselves is.

The 18th Congressional District of Texas is a mess. It needs new representation. Sheila Jackson-Lee has held that district since 1995. [18 years] That’s more than long enough. The voters deserve a fresh face, and a solid leader.

Toward that end, I’d like to strongly recommend voters choose to send Lt Col Sean Seibert to Congress in place of Jackson-Lee on Tuesday.

From Sean’s website:

Over his career he has led our nation’s greatest resources, its sons and daughters, in numerous deployments (to include Guatemala, Bosnia, Persian Gulf, and Afghanistan). In 2009 Sean was selected to join the 82d Airborne Division General Staff on their deployment to Afghanistan. Starting off as the lead planner for the Afghan National Police, whose stalwart performance was rated as immeasurable. The Commanding General selected Sean as his number one choice to lead the efforts at the key strategic board crossing in the Khyber Pass (where 80% of all NATO resources entered Afghanistan from Pakistan).

In this role Sean increased revenue by 203 Million Dollars, while improving commercial throughput from 17,000 to 22,000 per month. While leading the NATO effort on the border he facilitated regular discussions between the Afghan and Pakistani Government Officials.

Sean’s approach to the local Afghan community was one of constituents, where he regularly listened to their issues and negotiated with the Afghan Government and NATO to obtain what the people of the area needed and wanted. These efforts lead to job creation and economic growth in the area.

Raised in Texas, Sean is the eldest son of an immigrant mother (who became a U.S. Citizen in 1967) who instilled a multi-cultural view of the world and gave him the encouragement and confidence to be the first in the family to go to college obtaining a BA in Criminal Justice and furthering his education with a Masters in Organizational Management.

Sean Seibert is a fiscal conservative who believes in debt reduction and has a philosophy of pay as you go.
Honors and Awards:

*Meritorious Unit Commendation
*Superior Unit Award (2nd Oak Leaf)
*Bronze Star Medal
*Defense Meritorious Service Medal
*Meritorious Service Medal (1st Oak Leaf)
*Joint Commendation Medal
*Army Commendation Medal (4th Oak Leaf)
*Army Achievement Medal (5th Oak Leaf)
*Army Reserves Commendation Medal (4th Oak Leaf)
*National Defense Service Medal (2nd)
*Armed Forces Service Medal
*Southwest Asia Service Medal (2 Service Stars)
*Global War on Terrorism Service Medal
*Armed Forces Reserve Medal (w/ hourglass & 4 & M)
*NATO medal
*Afghan Campaign Medal with two service stars
*Army Service Ribbon
*Overseas Ribbon
*Army Reserves Overseas Training Ribbon (3)
*Kuwait Liberation Medal (Saudi Arabia)
*Kuwait Liberation Medal (Kuwait)
*Army Lapel Button

Houston has a huge Chinese-Asian community, here’s an interview Seibert did with Local Houston Chinese TV:

This is from Red Radio back in January:

Texans, please get out and vote on Tuesday. And everyone, please go read LaCheryl’s blog and thank her for standing up and speaking out when sitting down and shutting up would be a hell of a lot easier. We need millions more like her!

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Congresswoman Sheila Jackson-Lee Mixed Up In Massive Houston Medicare Fraud

By Gary P Jackson

Another stunning example of how cronyism and corrupt politicians are stealing tax payer money, giving it to crooks, and enabling criminal behavior.

Congresswoman Sheila Jackson-Lee, from the 18th congressional district of Texas, has deep ties to Riverside General Hospital in Houston. She also has close ties to top administrators who were just rounded up after massive Medicare fraud was uncover at the hospital.

M. Catharine Evans from American Thinker has the explosive details:

Systemic Medicare Fraud Under Houston’s Sheila Jackson Lee

Will Congresswoman Sheila Jackson Lee have to distance herself from Houston’s Riverside General Hospital now that top administrators have been caught in a major Medicare fraud scam?

Last week’s roundup makes me wonder why the Obama administration is cracking down on Medicare/Medicaid fraud in the first place. Aren’t they the ones shelling out hundreds of millions to their Solyndra-like cronies with no consequences?

Is it to make them look tough on crime, or is it to make sure the recovered monies are going into their own wallets at the end of the day?

Since her days on the Houston City Council, Jackson Lee has pushed to use city funds to keep Riverside’s doors open. At that time, the councilwoman suggested that the facility was a good investment for the city.

Jackson Lee’s interest in Riverside goes back to the ’80s when her husband Elwyn C. Lee, now University of Houston vice-chancellor (see video), served on Riverside’s board from 1981-1988. In his last year at Riverside, Mr. Lee was made chairman of that board, and over the years, husband and wife have been influential in keeping the financially strapped hospital open. Jackson Lee was voted into Congress in 1994, representing the 18th district, where Riverside is located.

The president of Riverside, his son, and five others were arrested on October 4 as part of a nationwide Medicare fraud sweep. Earnest Gibson III, chief executive officer of Riverside General Hospital for 30 years, has been charged with bilking $158 million out of Medicare over the last seven years.

His son, Earnest Gibson IV, was charged with thirteen counts, including money-laundering and conspiracy to commit health care fraud. The older Gibson became president around the same time Jackson Lee’s husband was appointed to the board in the early ’80s.

Friday’s arrests at Riverside came nine months after the arrest of Mohammad Khan, the hospital’s acting administrator, who pled guilty to his role in the Medicare fraud scheme and is now serving time.

Four months after Khan’s arrest, the Centers for Medicare and Medicaid Services suspended payments to Riverside. Gibson, who was still president at the time, sent a letter to all past and present supporters, friends, community leaders, and activists to help stop the federal government in its attempt to aggressively “shut down the 94-year old hospital.” Gibson asked his addressees to contact President Obama and Sheila Jackson Lee, congresswoman for Houston’s 18th district.

Ten days after CMS took action against Riverside, Jackson Lee wrote CMS Acting Director Marilyn Tavenner requesting she reconsider the agency’s decision.

It appears that, in suspending the Medicare payments you in effect have jeopardized some of the most vulnerable patients whose access to Medicare is literally their lifeline,” the congresswoman wrote in a letter.

This is classic corruptocrat strategy. Jackson Lee not only asks taxpayers who have already been bilked out of hundreds of millions of dollars to pour more money into an inner-city hospital run by alleged crooks, but she then blames them when her poor and vulnerable constituents are sacrificed to the streets while administrators and politicians rake in more dough.

It’s unlikely that Jackson Lee would not have been aware of the rife fraud and abuses occurring at Riverside over the last decade. Not only did it happen in her district, but Jackson Lee’s own husband served on the hospital’s board for seven years in the 1980s, when Gibson was president. The Lees’ interest in Riverside continues up to the present day.

In 2010, Jackson Lee personally handed Gibson a one-million-dollar check for the hospital’s new Post Traumatic Stress Clinic after she was able to secure the grant through the Department of Defense. Lee stated that the money would provide more resources for Houston veterans suffering from PTSD.

Last year, Riverside’s Edith Irby Jones Healthcare Center, a drug, alcohol, and addiction rehab facility, was awarded $19.4 million in FEMA funds for structural repairs following Hurricane Ike. The FEMA website explains that money is awarded to the state of Texas and then forwarded to the eligible applicant.

The storm severely damaged the second-story roof, allowing water into the 118,000-square-foot structure. The funding will cover the replacement of the entire Edith Irby Jones Facility.

This facility is a vital part of the south Houston medical community,” said FEMA Region 6 Administrator Tony Russell. “These grants will assist the state in its efforts to get the hospital and the city back on the road to recovery.

This award represents the largest in a series of FEMA-funded projects to date for Riverside General Hospital totaling $28.2 million.

In August 2012, a month after Jackson Lee appealed to CMS on behalf of Riverside’s indigent and vulnerable patients, 70% of the hospital’s Medicare payments were restored. CMS lifted the suspension even though federal investigators were only two months away from arresting Gibson and the others. Jackson Lee’s intervention seems to have caused even more taxpayer monies to be directed toward a hospital brimming with corruption.

CMS has yet to comment on why its people granted the congresswoman’s request to continue pumping money into Riverside despite the $116 million in Medicare fraud uncovered at the beginning of 2012, which led to the arrest of Mohammad Khan.

Amid a nationwide investigation and ongoing allegations of fraud involving cheating taxpayers out of millions in payments to ambulance services, home health care, and mental health clinics, could it be that CMS believed that Khan acted alone?

In February, the Houston Chronicle reported that Earnest Gibson IV, son of Riverside’s president, had previously been in business with Julian Vence Kimble. Kimble was found guilty in 2011 of operating an $8-million Medicare fraud scheme in which he used four ambulances to carry individuals posing as patients to various mental health clinics in the Houston area.

If Gibson IV’s association with a felon charged with Medicare fraud wasn’t a big enough red flag to shut down places like Riverside, what about U.S. Rep. Charles Boustany, Jr. (R-LA)’s testimony before a House Ways and Means subcommittee in early 2011, where he raised concerns about health care fraud, stating, “Nearly a year later, recent reports out of Texas suggest … providers continue to operate with impunity”?

Boustany was following up on a Houston Chronicle investigation into rampant Medicare fraud in the Houston area in which $488 million was paid out over 5 years for nonemergency ambulance services. In 2009 alone, Houston paid out $60 million in claims, compared to New York City, which paid only $7 million for the same year.

More here.

This is massive fraud, and like Evans, I have a hard time believing Congresswoman Lee didn’t know what was going on, especially since she and her family have been so intimately involved with the hospital for decades.

We can’t continue to tolerate this corruption. Obviously corrupt politicians like Sheila Jackson-Lee must be defeated this November, but more importantly, we must make sure we elect ethical men and women to replace them.

Of course, replacing these corrupt politicians is just the first step. We must demand Congress clean up it’s act. There is need for major reform. Reform creating laws that have actual teeth! It’s time members of Congress are not only are forced to live under the laws they create, but held to an even higher standard than the general public.

Congress is entrusted with trillions of tax payer dollars. OUR dollars. They do a rotten job of managing our money. The number of corrupt members of Congress who feed their cronies with our money is staggering. It’s time for this to come to an end, and people go to jail.

It’s time to clean house!

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Billions of Medicare Dollars Going to Castro, Cuba?

By Gary P Jackson

Like we don’t have enough to worry about, it seems that Medicare fraud has gone international. Mark Tapscott from the Washington Examiner reports there is growing concern money stolen from Medicare, through fraudulent claims, is ending up in Communist Cuba.

Senators Orrin Hatch and Tom Coburn, along with Congressman Peter Roskam say billions of dollars may be lost annually to these schemes:

Two U.S. senators and a representative worry that billions of tax dollars could be going to Cuba and other foreign countries via criminal schemes designed to defraud Medicare and Medicaid.

The schemes often involve the use of “nominees,” individuals who are paid to be fronts for the actual owners of corporate entities being used in the fraudulent operation. By concealing the identities of true owners, the approach invites its use to funnel tax dollars out of the country.

In a letter made public yesterday to Marilyn Tavenner, acting administrator of the Center for Medicare and Medicaid, senators Orrin Hatch, R-UT, and Tom Coburn, R-OK, were joined by Rep. Peter Roskam, R-IL, said they fear billions of tax dollars are being lost annually as a result.

Clearly, the program vulnerabilities that facilitate billions of dollars to be stolen from the Medicare program each year also allow for some of that money to be funneled to foreign countries,” the three congressmen said.

While the fraud itself is unacceptable, the loss of American dollars to foreign countries because of flaws in our system is totally unacceptable. The American people deserve the peace of mind to know that federal officials are doing everything they can to safeguard taxpayers’ dollars and the Medicare program.

Thus far, it does not appear that CMS has addressed the concept of nominee owners, false storefronts, and shell companies in any of its enrollment regulations or its Provider Screening statement of work,” they said.

Earlier this week, federal officials in Miami charged Oscar Sanchez in connection with a criminal operation that resulted in an estimated $31 million going to Cuban banks.

Prosecutors say Oscar Sanchez, 46, was a key leader in a group that funneled $31 million in Medicare dollars into banks in Havana — the first such case that directly traces money fleeced from the beleaguered program into the Cuban banking system,” the Miami Herald reported Monday.

Most of the money moved through an intricate web of foreign shell companies before ending up in Cuba, to avoid being detected in the United States, said investigators,” the Herald said.

Also earlier this week, federal officials announced the capture of two other individuals who had been involved in multi-million dollar frauds with overseas connections. In one, Irina Shelikhova was arrested Monday at JFK Airport in New York when she tried to re-enter the country from the Ukraine.

From approximately March 2005 until July 2010, Shelikhova and her co-conspirators allegedly paid cash kickbacks to Medicare beneficiaries to induce them to receive unnecessary physicians’ services, physical therapy, and diagnostic tests at the medical clinics,” according to the Inspector-General of the Department of Health and Human Services.

The co-conspirators created fraudulent medical records for these beneficiaries and then filed false claims with Medicare for these medical services, which either were never provided or were not medically necessary,” the HHS IG said.

Shelikhova and her co-conspirators are believed to have defrauded Medicare of as much as $70 million.

In the second case, federal officials arrested Miguel Cabello last week when he attempted to re-enter the country through Champlain, New York.

Cabello fled the country to Cuba in July 2008 after being indicted on health care fraud charges. “Cabello submitted approximately $2.1 million in fraudulent Medicare claims on behalf of south-Florida-based OB Pharmacy, Inc., and he received approximately $1.3 million in Medicare payments,” according to the HHS IG.

Before Cabello’s involvement, OB Pharmacy, a durable medical equipment company that specialized in aerosol medications, submitted $151,572 in Medicare claims and was paid approximately $58,653.

Around April 2008, Cabello became vice-president of OB Pharmacy. Investigators have concluded that OB Pharmacy submitted claims to Medicare for services that were not rendered, including approximately 10 claims for deceased beneficiaries.

Investigators interviewed physicians who stated that they did not know the OB Pharmacy patients in question nor did they prescribe the medication purportedly provided to them.

In their letter to Tavenner, Hatch, Coburn and Roskam cited a University of Miami report that quoted a former Cuban intelligence officer saying there are “strong indications” that the Castro government aids Medicare fraud, especially in South Florida, and provides safe harbor for individuals involved in those efforts.

If confirmed, this indicates that Medicare program dollars are not only funding international criminal syndicates, but may be helping prop up the Castro government,” the congressmen said.

Read more here

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