Dr. Rousseau and Six Therapists Charged in $63 Million Miami Medicare Fraud Scheme By Tod Aronovitz | 07/17/13 | 0 Comment

Dr. Roger Rousseau, a psychiatrist who has been practicing in South Florida for almost 40 years, was arrested Tuesday for allegedly scheming to steal $63 million in a Miami Medicare fraud scheme. The 71 year-old former medical director of a mental-health clinic that is no longer in operation has been accused of conspiring to commit health care fraud with six other Miami therapists: Doris Crabtree, 61, Angela Salafia, 65, Liliana Marks, 46, Ruben Busquets, 49, Alina Fonts, 47, and Blanca Ruiz, 59.

According to the charges, Rousseau routinely signed false medical records without even looking at the information and, in most instances, without ever meeting with patients. The indictment also asserts the six therapists altered the clinic’s medical records to support phony Medicare claims for psychotherapy services that were unnecessary since many of the patients suffered from dementia or Alzheimer’s and would have not been helped by the therapy.

Rousseau was released on $375,000 bond, and all six therapists were also granted bonds after their first appearances in federal court. According to Rousseau’s attorney, the charges don’t match the allegations against his client.

This case is an offshoot of another Medicare fraud case in which Armando “Manny” Gonzalez was sentenced in February to 14 years in prison after being found guilty of Medicare fraud. The charges stemmed from operations in the chain of clinics he owned in South Florida and North Carolina. That chain, Health Care Solutions Network, is where Rousseau served as the medical director.

Gonzalez, 50, was a previously convicted cocaine trafficker. According to federal prosecutors, he collected $28 million in Medicare payments for psychotherapy sessions that patients in his clinics didn’t need or receive between 2004 and 2011. In the mid-2000s, Gonzalez opened a pair of mental-health clinics in the Kendall and Cutler Bay areas, and by 2008, moved to North Carolina to evade federal agents who were looking into his operations.

Agents with the FBI and Health and Human Services arrested him last year along with others involved in his company, including patient recruiters and assisted-living-facility operators who took kickbacks for supplying him with countless Medicare beneficiaries. Almost all of those defendants have pleaded guilty and have gone to jail.

How to Report Miami Medicare Fraud
Healthcare or medical billing employees who have inside knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami Qui Tam law firm of ARONOVITZ LAW routinely works with Miami whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / Qui Tam lawyer Tod Aronovitz to discuss a case.