• DOJ Secures Guilty Pleas From Owners of Mental Health Corporation in $200 Million Medicare Fraud Scheme
  • April 20, 2011 | Author: Michael E. Paulhus
  • Law Firm: King & Spalding LLP - Atlanta Office
  • On April 14, 2011, Lawrence Duran and Marianella Valera, the owners of American Therapeutic Corporation (ATC), pleaded guilty to all counts in a superseding indictment charging Duran with 38 felony counts and Valera with 21 felony counts for a scheme that resulted in the submission of over $200 million in fraudulent claims to Medicare over eight years.  The investigation and prosecution were brought as part of the Medicare Fraud Strike Force operations in Miami.

    According to the superseding indictment, the defendants “paid kickbacks to owners and operators of assisted living facilities (ALFs) and halfway houses and to patient brokers in exchange for delivering patients to ATC and ASI [American Sleep Institute],” a related company.  Press Release, Department of Justice, Two Owners of Miami-Area Health Care Corporation Plead Guilty to Orchestrating $200 Million Medicare Fraud Scheme (Apr. 14, 2011).   They then “billed Medicare for mental health services that were illegitimate or never provided.”  Id.  To conceal the scheme, they set up complex money laundering operations to hide the proceeds and caused the alteration of patient files to make it appear that patients qualified for and were being treated for mental health services at their facilities.  Id.

    The indictment charged Duran and Valera with “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.”  Id.  Sentencing is set for July 13, 2011.