AMARILLO, Texas â€” A licensed psychiatrist from San Angelo, Texas, Robert Hadley Gross, 58, was sentenced yesterday by U.S. District Judge Mary Lou Robinson to 71 months in federal prison, fined $100,000 and ordered to pay $1,832,869 in restitution, announced U.S. Attorney John Parker of the Northern District of Texas.
Gross pleaded guilty in September 2015 to one count of health care fraud stemming from a scheme he ran to defraud Medicare and Medicaid by submitting claims for services not rendered in the manner billed, including submitting claims for services allegedly rendered after patientsâ€™ deaths.Â He has been in federal custody since his arrest in mid-October 2014 on related charges outlined in a federal indictment.Â Gross also must forfeit nearly $2 million seized from various accounts.
According to documents filed in the case, beginning in January 2009 and continuing until approximately June 20, 2014, Gross filed, and caused to be filed, claims against Medicare, Medicaid, and other health insurance carriers, for payment for services that were never rendered and services that were billed using inappropriate CPT codes.
Gross regularly submitted claims for services rendered to nursing home residents in and around San Angelo and he also regularly submitted claims for services provided to clients of mental health and mental retardation (MHMR) organizations in San Angelo, Midland, and Abilene, Texas, in addition to claims for services provided to foster care children in Brownwood, Texas.
As part of his scheme, Gross filed claims against Medicare, Medicaid, and other health insurance carriers for services for nursing home patients on dates he did not actually render services to patients.Â In those instances, the patients may have died or been discharged before Gross allegedly visited them in the nursing home.
The Federal Bureau of Investigation, Health and Human Services Office of Inspector General, and Medicaid Fraud Control Unit, Office of the Texas Attorney General investigated.Â Assistant U.S. Attorney Ann Cruce-Haag and Deputy Criminal Chief Assistant U.S. Attorney Denise Williams prosecuted and Assistant U.S. Attorney Megan Fahey handled the forfeiture.