The Justice Department may want a do-over in a major Medicare fraud case.
On Tuesday, a Miami federal jury failed to reach a verdict in the prosecution of a psychiatrist and three therapists charged with bilking the government with phony patients and bogus bills totaling $63 million.
The 12-person jury deadlocked on the main charge accusing Dr. Roger Rousseau and three state-licensed therapists — Doris Crabtree, Angela Salafia and Liliana Marks — of a fraud conspiracy while working for Healthcare Solutions Network, a Miami-Dade chain of mental health clinics.
The jurors also hung on other fraud charges against the physician, the chain’s medical director, but acquitted the three therapists of related offenses.
“It is a great result,” Rousseau’s defense attorney, Sam Rabin, told the Miami Herald on Wednesday “Anytime you live to fight another day is a good day.”
Justice Department prosecutors must now decide whether they want to retry the case — built on allegations of fabricated medical records, bribed patient suppliers and falsified claims — after a nearly one-month trial before U.S. District Judge Robert Scola.
The only consolation for prosecutors: After revealing their struggles in a note to Scola, the jury eventually found two registered counselors, Alina Fonts and Blanca Ruiz, guilty of the central conspiracy charge and Fonts guilty of two related offenses.
The case grew out of a federal investigation into a local businessman: Armando “Manny” Gonzalez, a convicted cocaine trafficker who joined the Medicare rackets in the mid-2000s, had opened three 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 they caught up with him.
Last year, Gonzalez was sentenced to 14 years in prison. He pleaded guilty to fleecing Medicare and laundering the proceeds to support an affluent lifestyle — including nearly $1 million seized after his arrest in 2012 as well as a one-acre home, vehicles and other assets in Hendersonville, N.C..
In addition to Gonzalez, 12 other defendants pleaded guilty or were convicted at trial. They either worked for his therapy business or operated assisted-living facilities that supplied patients to his clinics.
The ALF operators took bribes from Gonzalez in exchange for supplying a steady stream of patients, many of whom suffered from dementia and Alzheimer's disease. They could not have benefited from the treatment at Healthcare Solutions Network, prosecutors said.
Gonzalez's clinics — accused of entertaining patients with TV and movies instead of providing actual group psychotherapy sessions — collected $28 million in taxpayer-funded Medicare payments from 2004 to 2011.
In the sequel case, six defendants stood trial in November. A seventh defendant, therapist Ruben Busquets, had pleaded guilty to the fraud conspiracy charge and agreed to testify for the government.
An indictment claimed that Rousseau, the psychiatrist, routinely signed what he knew were altered medical records and, in most instances, without ever meeting with patients.
The indictment also accused the therapists and counselors of fabricating patient records to back up fraudulent claims for therapy sessions that were not necessary or provided.
Jurors struggled in their deliberations, which began last Friday. “We regret to inform you we are not able to reach a unanimous decision on count 1 [the conspiracy charge],” the jurors wrote the judge on Tuesday. “We have not moved forward to any other counts.”
Scola urged them to find consensus. But in the end, only Fonts and Ruiz were convicted of defrauding Medicare.