A federal judge in Miami has sentenced local man who had owned the nation’s largest community mental health center chain to 50 years in prison for his role in a $205 million Medicare fraud scam.
Lawrence Duran, 49 of Miami has been sentenced to 50 years in prison by a federal judge for his part in a $205 million Medicare fraud scam. According to authorities, Duran, who had owned the largest community mental health center chain in the United States “ preyed on patients with Alzheimer’s disease and severe dementia, orchestrating an elaborate scam where staff forged patient charts to bill Medicare for therapy sessions and other services it never delivered.”
Lawrence Duran had also developed an organization to lobby Congress for additional funds to support the mental health services his fraud scheme purported to provide, and was even be viewed on a YouTube video visiting U.S. Rep. Ileana Ros-Lehtinen to discuss health care reform, saying his centers treat more than 450 patients daily.
Prosecutors also reported that both employees and doctors at American Therapeutic Corp. and its sister companies were told to amend diagnoses and medications to “make it seem that they qualified for expensive sleep studies and mental health treatments.”
However, patients with acute mental illness and about to be hospitalized were never provided with the intensive counseling they should have received.
In addition, it was shown that ATC also paid the owners of assisted living facilities and halfway houses to round up patients for their seven mental health centers in south and central Florida for therapy sessions that were never held.” In some cases, elderly and infirm patients were left in rooms for hours and weren’t cognizant of where they were or what was happening around them,” authorities said.
“Instead of providing patients with the treatment they needed, Mr. Duran and his co-conspirators used them as props to fill their fraudulent mental health centers, said Assistant Attorney General Lanny A. Breuer of the Criminal Division, who added that certain patients “also cashed in on the scheme by providing their Medicare numbers, while others were not coherent enough to demand kickbacks.”
The indictment stated that Duran and ATC co-owner Marianella Valera were found to have manipulated records so patients would have to stay longer at the facility, racking up higher Medicare bills. The pair were arrested in a huge bust just about a year ago and pleaded guilty to multiple charges, including health care fraud and money laundering. Duran was also ordered to pay more than $87 million in restitution at yesterday’sentencing. Marianella Valera is scheduled to be sentenced next week.
Anyne here in Connecticut who thinks that they may be a victim of Medicare fraud can make a report to the State Attorney General’s Office , 55 Elm St., Hartford, CT 06106, 860 808-5318, or contact the Office of the Inspector General’s hotline, which offers a confidential means for reporting vital information. The Hotline can be contacted by calling 800 447-8477. You can also write to the Office of the Inspector General HHS TIPS Hotline, P.O. Box 23489, Washington, DC 20026
However, before contacting the Medicare claims processing company, carefully review the facts as you know them and as shown on the Medicare Summary Notice. Write down: The provider in question’s name and any identifying number you may have; the item or service you are questioning; the date on which the item or service was supposedly furnished; the amount approved and paid by Medicare; the date of the Medicare Summary Notice; the name and Medicare number of the person who supposedly received the item or service; the reason you believe Medicare should not have paid; and any additional information you may have showing that the claim for the item or service should not have been paid by Medicare.