Mental Illness and Sleep Centers Fraudulently Bill Medicare for Hundreds of Millions

Masquerading as owner/operators of treatment centers for patients with severe mental illness, Marianella Valera, the president of American Therapeutic Corporation, and Lawrence S. Duran, the president of Medlink Management Group, Inc., have effectively admitted that their respective corporations were little more than shams that scammed the nation’s healthcare system out of more than $200 million dollars.

“ATC and Medlink, and their owners, have now pleaded guilty to perpetrating a massive $200 million Medicare fraud scheme in South Florida,” said Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division. “The fraud scheme was staggering in scope, and those who concocted the scheme exhibited a complete disregard for the elderly, infirm and disabled victims who were used to commit it. Today’s guilty pleas mark an important step forward in our effort to hold accountable everyone — and every entity — involved in the scheme, and to recover the maximum amount possible on behalf of American taxpayers.” DoJ’s indictment alleged that:

Duran, Valera and others caused the alteration of patient files and therapist notes for the purpose of making it appear, falsely, that patients being treated by ATC qualified for PHP treatments. According to court documents, Duran and Valera also instructed employees and doctors to alter diagnoses and medication types and levels to make it falsely appear that ATC patients qualified for PHP services.

Additionally, as is becoming more and more frequent in Medicare fraud, the defendants billed for unqualified patients who neither needed nor benefited from the treatment — in this case, sleep studies.

“No matter what the scheme or how elaborately it was disguised, personal and corporate greed by these two corporations and their owners defrauded taxpayers of millions of dollars,” said Special Agent in Charge John V. Gillies of the FBI’s Miami Field Office. “Ultimately, health care fraud robs from the elderly and disabled.”

The two corporations have entered into guilty pleas as have some of the individuals involved, but at least one of the charged individuals awaits trial by jury and remains innocent until proven guilty.

To report False Claims Act violations, contact Frohsin & Barger.