Miami doctor and therapists charged with $63 million Medicare-fraud scam

 

jweaver@MiamiHerald.com

A psychiatrist who has been practicing in Miami since the 1970s was arrested Tuesday along with six therapists on charges of scheming to steal $63 million from the taxpayer-funded Medicare program.

Roger Rousseau, 71, the former medical director for a defunct mental-health clinic operation, was indicted on charges of conspiring to commit health care fraud.

Rousseau, who had his first appearance along with the other defendants in federal court, was released on a $375,000 bond.

“We don’t think the evidence supports these allegations,” said Miami defense attorney Sam Rabin. “We look forward to defending Dr. Rousseau against these charges in court.”

Rousseau served as the medical director of Health Care Solutions Network in Florida, owned by Armando “Manny” Gonzalez. The owner was sentenced in February to 14 years in prison after pleading guilty to Medicare fraud charges stemming from operations in his chain of clinics in South Florida and North Carolina.

Gonzalez, 50, a previously convicted cocaine trafficker, pocketed $28 million in Medicare payments for purported psychotherapy sessions that patients didn’t need or receive between 2004 and 2011, according to federal prosecutors.

In the mid-2000s, Gonzalez opened a pair of mental-health clinics in the Kendall and Cutler Bay areas. By 2008, he had moved himself and his business to North Carolina to stay one step ahead of federal agents.

But agents with the FBI and Health and Human Services caught up with him, leading to the arrest of Gonzalez and a dozen others involved in his company, including patient recruiters and assisted-living-facility operators who took kickbacks for supplying a stream of Medicare beneficiaries.

Since their arrests last year, almost all of those defendants have pleaded guilty and been imprisoned.

In the spin-off case, Rousseau was charged along with six Miami therapists: Doris Crabtree, 61, Angela Salafia, 65, Liliana Marks, 46, Ruben Busquets, 49, Alina Fonts, 47, and Blanca Ruiz, 59. They also were granted bonds Tuesday.

According to the indictment, Rousseau routinely signed what the psychiatrist knew to be fabricated and altered medical records without ever reviewing the materials and, in most instances, without ever meeting with patients.

The indictment, filed by prosecutors Allan J. Medina and William Parente, alleges the six therapists fabricated the clinic’s medical records to back up false Medicare claims for psychotherarpy services. Those purported treatments were not medically necessary because many of the patients suffered from dementia or Alzheimer’s and could not have benefited from the therapy.

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