A picture has emerged in Houston of kickbacks and schemes to steer patients between group homes and outpatient mental health clinics offering "partial hospitalization" programs that bill Medicare. The clinics often operate out of strip-mall storefronts or even single-family suburban homes. A Houston Chronicle investigation last year noted that more than 75 percent of all Medicare spending in Texas on outpatient psychiatric programs is flowing into just one county: Harris County, where Houston is located. Private ambulance companies in Houston also bill Medicare to ferry the patients back and forth. Series reporter Terri Langford revealed that private ambulance operators in Harris County billed Medicare in 2009 almost nine times as much as companies in New York City.