Long Prison Stretch May Follow Big Medicare Scam

     (CN) – A Miami couple pleaded guilty to submitting over $200 million in fraudulent Medicare claims through their mental-health corporation, the Justice Department said.




     Lawrence Duran and Marianella Valera, who ran American Therapeutic Corp., were charged with a total of 59 felony counts related to their health care fraud.
     American Therapeutic operated partial-hospitalization programs in seven different places in Florida that treated severely mentally ill patients. The couple also ran a related company, the American Sleep Institute, to submit fraudulent Medicare claims, prosecutors claimed.
     Between 2002 and 2010, Duran and Valera bribed “patient brokers, assisted living facility owners, and Halfway House owners who provided and had access to Medicare beneficiaries” to recruit patients to the clinics for treatment that was either medically unnecessary or not performed at all, the indictment says.
     To conceal the Medicare payments, Duran and Valera allegedly ran a money-laundering operation through their company Medlink Professional Management Group. According to the indictment, the defendants transferred millions of dollars to Medlink to convert the Medicare claims into cash.
     Duran, 49, was charged with 38 felony counts and Valera, 40, with 21 felony counts, including conspiracy to commit health care fraud, health care fraud, conspiracy to pay and receive illegal health care kickbacks, conspiracy to commit money laundering, money laundering and structuring to avoid reporting requirements. They pleaded guilty to all counts, which each carry minimum sentences of five to 20 years.
     Margarita Acevedo, the marketing director for American Therapeutic, was also charged as a co-conspirator and pleaded guilty on April 7. Judith Negron, vice president and co-owner of Medlink, has pleaded not guilty.
     Duran and Valera are scheduled for sentencing on July 13.

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