Friday, April 15, 2011

"Nation's Largest Mental Health Racket" - $200 Million Fraud

Subject: "Nation's Largest Mental Health Racket" - $200 Million Fraud
Date: Fri, 15 Apr 2011 12:53:52 -0400
From: <Psych_News@psychsearch.net>
To: <Psych_News@psychsearch.net>

Licensed mental health counselor Marianella Valera and her husband Lawrence S. Duran directed the nation’s largest mental health racket and could face more than 20 years in prison.

Psychiatrists Mark Willner, Alan Gumer and Alberto Ayala also face criminal charges in the scam.

http://www.miamiherald.com/2011/04/13/2167010/couple-to-plead-guilty-in-major.html


Miami Herald

Couple pleads guilty in massive Medicare fraud case

A Miami couple charged with running the nation’s largest mental health scam pleaded guilty to billing the federal program for bogus therapy.
BY JAY WEAVER

April 14, 2011

Dressed in khaki prison garb, Lawrence S. Duran and Marianella Valera chatted and smiled at each other in federal court Thursday before pleading guilty to a massive conspiracy to steal $200 million from the taxpayer-funded Medicare program.
The Miami couple directed the nation’s largest mental health racket and could face more than 20 years in prison.

There was only one person in the audience — Duran’s ex-wife, Carmen Duran, the mother of their three children.


“It breaks my heart,” the North Miami woman said. “I can only think of my kids. He’s a great dad, loving and supportive.”

Duran, 49, and Valera, 40, owned a chain of seven mental health clinics operated by a Miami-based company called American Therapeutic Corp. The couple, along with their company and subsidiaries, were indicted in October with conspiring to defraud Medicare in a major U.S. Justice Department case that includes 22 other defendants, from senior company employees to psychiatrists to patient-recruiters. In February, more charges were added to the couple’s initial indictment.

“They reaped millions in illegal profits by operating a sham mental healthcare company that provided unnecessary and illegitimate treatments to patients, many of whom were recruited through bribes and kickbacks, and then they laundered the proceeds,” Lanny A. Breuer, assistant attorney general of the Justice Department’s criminal division, said in a statement.
He called the $200 million scam “a staggering sum.”

A week ago, the company’s marketing director, Margarita Acevedo, 41, became the first defendant to plead guilty when she admitted that she played a central role in the conspiracy. Acevedo, who is cooperating with authorities as part of her plea agreement, said she paid millions in kickbacks to South Florida recruiters associated with assisted-living facilities and halfway houses in exchange for supplying therapy services to thousands of patients who didn’t need them.


Among American Therapeutic’s patients: elderly people suffering from dementia and Alzheimer’s disease who could not have benefited from the costly group therapy sessions, according to prosecutors.

“In fact, these patients were not eligible for this program, services were not provided as billed and patient charts were altered so that Medicare inspections would not uncover the fraud,” wrote a magistrate judge, summarizing the government’s case before ordering the couple’s pre-trial detention in November.

Duran and Valera, co-owners of American Therapeutic, pleaded guilty to the 38-count indictment after extensive negotiations for a plea deal failed. It charged them with conspiring to defraud Medicare by filing false claims for mental health services; paying kickbacks to patients, patient-recruiters and operators of assisted-living facilities, and laundering money through a subsidiary company called MedLink.

A major dispute over how much the couple bilked from Medicare must still be resolved before they are sentenced. Their lawyers, Lawrence Metsch and Arthur Tifford, have argued that the figure should be $83 million, the actual amount the federal program paid their company from 2003 to 2010. Justice Department trial attorney Jennifer Saulino has argued that the figure should be $200 million, the amount their company billed to Medicare — or the “intended loss.”

The calculation of the loss to Medicare will have a significant influence on their prison sentences, which could range from 10 to 20-plus years.


U.S. District Judge James Lawrence King recently rejected the couple’s bid for a jury trial to determine the loss amount. He will address that issue at their sentencing.

The feds have frozen the couple’s personal and corporate bank accounts. They also possess about $7 million in assets, such as luxury cars, real estate and jewelry that authorities seized under a temporary restraining order.

According to court records, the FBI and IRS have examined numerous bank accounts belonging to American Therapeutic, Duran and Valera. But investigators have found only $750,000, noting that “millions of dollars remain unaccounted for.”


Both Duran, who was born in New York, and Valera, a native of Peru, are U.S. citizens. They are being held at the Federal Detention Center in Miami because a magistrate judge determined that they were flight risks.

Just the tip of the iceberg as far as I am concerned.  I believe this racket is so huge that it may entail close to a TRILLION dollars nation-wide.

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