Houston-Area Physician and Anesthesiologist Sentenced to 84 Months in Prison for Role in Health Care Benefit Scheme

A Houston-area physician and anesthesiologist at two registered pain clinics, Texas Pain Solutions and Integra Medical Clinic, was sentenced today to seven years in prison for his role in fraudulently billing health care programs for at least $5 million dollars in medical tests and procedures, and for the role his fraud played in multiple patient deaths. 

Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division, U.S. Attorney Ryan K. Patrick of the Southern District of Texas, Montgomery County District Attorney Brett Ligon, Special Agent in Charge Will R. Glaspy of the Drug Enforcement Administration’s (DEA) Houston Division, and Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office made the announcement.

Rezik Saqer, 66, of Houston, Texas, was sentenced by Chief U.S. District Judge Lee H. Rosenthal of the Southern District of Texas.  Chief Judge Rosnethal also ordered the defendant to pay $5 million in restitution.  Saqer pleaded guilty on July 3, 2019, to one count of conspiracy to commit health care fraud.

According to the evidence presented at sentencing, Saqer’s health care fraud scheme involved luring vulnerable patients to his clinics by prescribing powerful opioid narcotics, and then requiring the patients to submit to unnecessary and dangerous procedures and tests, which were often performed by Saqer’s unlicensed staff and fraudulently billed to health care providers.  Saqer’s scheme contributed to multiple overdose deaths, as well as the death of a young family in an auto accident involving one of Saqer’s patients, according to the evidence.  

According to the court’s judgment, Saqer was responsible for fraudulently billing health care providers for at least $5 million. 

This case was investigated by the Montgomery County District Attorney’s Office, DEA, and FBI.  Trial Attorneys Andrew Pennebaker and Devon Helfmeyer of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Tina Ansari of the Southern District of Texas are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The year 2020 marks the 150th anniversary of the Department of Justice.  Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.

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At the program operations level, staff should be appropriately trained in Agile methods. And at an organizational level, a best practice is to create a culture that supports Agile methods. Requirements development and management. Requirements—sometimes called user stories—are important in making sure the final product will function as intended. Best practices in this area include eliciting and prioritizing requirements and ensuring work meets those requirements. Acquisition strategy. Contractors may have a role in an Agile program in government. However, long timelines to award contracts and costly changes are major hurdles to executing Agile programs. One way to clear these hurdles is for organizations to create an integrated team with personnel from contracting, the program office, and software development. Clearly identifying team roles will alleviate bottlenecks in the development process. Figure 2. Different roles come together to make an Agile software development team. Program monitoring and control. Many Agile documents may be used to generate reliable cost and schedule estimates throughout a program’s life-cycle. Metrics. It is critical that metrics align with and prioritize organization-wide goals and objectives while simultaneously meeting customer needs. Such metrics in Agile include the number of features delivered to customers, the number of defects, and overall customer satisfaction.  Opportunities Flexibility. An Agile approach provides flexibility when customers’ needs change and as technology rapidly evolves. Risk reduction. Measuring progress during frequent iterations can reduce technical and programmatic risk. For example, routine retrospectives allow the team to reflect upon and improve the development process for the next iteration. Quicker deliveries. Through incremental releases, agencies can rapidly determine if newly produced software is meeting their needs. With Agile, these deliveries are typically within months, instead of alternative development methods, which can take years. Challenges GAO has previously reported on challenges the federal government faces in applying Agile methods; for the full report see GAO-12-681. Lack of organizational commitment. For example, organizations need to create a dedicated Agile team, which is a challenge when there is an insufficient number of staff, or when staff have several simultaneous duties. Resources needed to transition to Agile. An organization transitioning to Agile may need to invest in new tools, practices, and processes, which can be expensive and time consuming. Mistrust in iterative solutions. Customers who typically see a solution as a whole may be disappointed by the delivery of a small piece of functionality. Misaligned agency practices. Some agency practices, such as procurement, compliance reviews, federal reporting, and status tracking are not designed to support Agile software development. Policy and Context Questions In what ways can Agile help the federal government improve the management of IT acquisitions and operations, an area GAO has identified as high risk for the federal government? How can policymakers implement clear guidance about the use of Agile software development, such as reporting metrics, to better support Agile methods? How might resources need to shift to accommodate the adoption of Agile in federal agencies? What risks could those shifts pose? What updates to agency practices are worth pursuing to support Agile software development? For more information, contact Tim Persons at (202) 512-6888 or personst@gao.gov.
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