Lawrence Duran, Miami resident and owner of health care company, American Therapeutic Corporation (ATC) has received the longest prison sentence ever imposed in a Medicare fraud case with 50 years in prison when he orchestrated a $205 million Medicare fraud scam. ATC’s other owner, Marianella Valera, was sentenced to 35 years in prison.
Duran, Valera and co-defendants have been ordered to pay more than $87 million in restitution between the lot of them. After their prison sentences they have each been sentenced to three years of supervised release.
Duran and Valera pleaded guilty on all counts charged on April 14 of this year. Duran was charged with 38 felony counts and Valera with 21 – note the difference in serving time. They both admitted to committing health care fraud and conspiracy to pay and receive illegal health care kickbacks along with conspiracies to commit money laundering, actually laundering money and structuring to avoid reporting requirements.
In pleading guilty, Duran and Valera admitted that they orchestrated and executed a scheme to defraud Medicare beginning in 2002 and continuing until they were arrested in October 2010. Duran and Valera submitted false and fraudulent claims to Medicare through ATC, a Florida corporation headquartered in Miami that operated purported partial hospitalization programs (PHPs) in seven different locations throughout South Florida and Orlando. A PHP is a form of intensive treatment for severe mental illness. Duran and Valera also used a related company, American Sleep Institute (ASI), to submit fraudulent Medicare claims. – Source.
Court documents show that Valera and Duran bribed and paid kickbacks to others to recruit Medicare beneficiaries to attend ATC and ASI where they billed Medicare for treatments supposedly provided. Apparently the procedures were unnecessary or never provided in the first place. The two sentenced for this scam supported bribes and kickbacks through laundering money via their other company Medlink Professional Management Inc., when they attempted to conceal the illicit conversion of Medicare payments to cash.
Since the owners have been arrested in October 2010 both companies have been “defunct”. ATC and Medlink pleaded guilty which resulted in an $87 million restitution and five years of probation per criminal count. Not to mention the jail time its’ owners will serve.
Since its inception in March 2007, the Medicare Fraud Strike Force operations in nine locations have charged more than 1,140 defendants that collectively have billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers. – Source.
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