Dr. Robert Gross

Robert Gross sentenced to federal prison for 71 months

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Published: 02 August 2017

Posted by: Sabrina W. Habib

Robert Gross was sentenced to 71 months in federal prison after he pleaded guilty to health care fraud. The 58 year old San Angelo psychiatrist was ordered to pay restitution as well, said U.S. Attorney John Parker, on Thursday.
Gross admitted that he had defrauded Medicaid and Medicare by submitting claims for service he did not provide. This was in September. He used inappropriate billing codes in his workings. In some cases, he submitted claims for services he had allegedly provided even after the death of patients involved. These fraudulent claims happened between January 2009 and June 2014, according to court documents. Gross had filed claims for patients of MHMR organizations in Abilene, San Angelo and Midland. Brownwood foster care children were also used by him when he claimed services.
Robert Gross has been in custody since October 2014, which was when he was arrested. The investigation had been going on in full swing at that point. He was sentenced by U.S. District Judge Mary Lou Robinson. He was also asked to pay a fine of $100,000. This was in addition to the $1,832,869 that he was asked to pay in restitution, according to a news release.
The actions that the Medical Board took are as follows:
On 17th May 2002, Gross had his physician’s license limited in the state of Texas. This meant that he could not practice in the state until he appeared for final conclusion before the board, until all matters of a legal nature with the United States government were resolved with respect to the investigation.
On 12th December 2004, Gross and the board agreed on an order in which his license was revoked. According to the agreement, his the revocation on his license was stayed. However, he was placed on probation for a period of 12 years. Other restrictions placed on the doctor were that he had to undergo psychiatric evaluation, pass the medical jurisprudence and special purpose exams successfully, not practice medicine until the board was given evidence that he was competent to do so, attend and complete any assessments that were deemed necessary at the Colorado Institute for Physician Evaluation. These actions were the outcome of a felony conviction.
On 7th April 2006, the order that was dated on 12th December 2004 was allowed to be modified. It said that Gross was allowed to return to practicing medicine in the state of Texas, but that he was only pursuant to a program of preceptorship directed by the Medical Review and Accrediting Counsel. The Counsel is approved by the director of the Board, and is an affiliate of the Federation of State Medical Boards.
On 25th August 2006, the 7th April 2006 order clarified with the entering of a Nunc Pro Tunc order.
On 21st August 2009, the board issued a new order. This order denied the termination of the 2004 order that put Gross in a 12 year probationary period. The original order had already been modified in 2006. The 2006 order also said that Gross would have demonstrate an acceptable level of medical competency before he could resume practice. Because of his criminal contempt charge and federal felony conviction, Gross had not practiced medicine since 1996 in Texas. After the 2006 modification of the original 2004 order, he had to limit his practice to institutional or group settings that were approved by the board. He also had to finish a preceptorship program. Gross said that he had served close to five years of his probationary term, and that there was a shortage of child psychiatrists in his location. He also said that he found it hard to get approval for hospital privileges as well as insurance reimbursement. The board denied the request for termination that Gross had put forward for the following reasons: his original ordered was entered for rehabilitative and disciplinary purposes. The board felt that he had not shown a good enough reason for the reduction of the 12 year term.
On 28th August 2012, the board filed a formal complaint – Soah Docket 503-12-8082.MD.
On 8th February 2013, Gross and the board entered into an agreed order that was mediated. According to the new order, Gross had to have his practice evaluated within 90 days by the practice counseling services of the Texas Medical Association. The evaluation was to have a special emphasis on coding and billing, operational assessment and risk management. Gross had to complete 18 hours of CME within one year – four hours each in medical billing and medical coding, besides 10 hours in risk management. Gross had not adequately supervised the actions of those under his supervision, found the board. He did not maintain proper medical records and was subject to disciplinary action by colleagues. Soah Docket 503-12-8082.MD. – the order resolved this complaint that was filed at the State Office of Administrative Hearings.

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