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.

It's difficult to comprehend how all of this cheating and corruption went on under Jackson Lee's nose without her knowing about it.  The congresswoman claims to champion the most vulnerable members of her district while taxpayer monies designated for their care ends up in administrators' pockets.

This is why Washington, D.C. is broken.  Like Jackson Lee, too many politicians think that redistributing other people's hard-earned money into the pockets of potential felons is okay as long as they get political benefit.

Read more M. Catharine Evans at Potter Williams Report.

If you experience technical problems, please write to