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American Therapeutics owner gets 35 years for scam
By Palm Beach Business.com
MIAMI — Judith Negron, one of the owners of a South Florida mental health company that was actually nothing more than a massive Medicare fraud scheme, will be joining two of her colleagues as a long-term resident of a federal prison.
Federal Judge James Lawrence King on Friday sentenced Negron, 40, to 35 years in prison for her role in the scam, which took Medicare for $205 million. Negron, one of the owners of American Therapeutics Corp., also must pay $87 million in restitution, plus serve three years of supervised release.
Two other ATC owners, Lawrence Duran and Marianella Valera received 50 and 35 years respectively when sentenced in September.
Last August, a federal jury found Negron guilty of 24 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.
According to prosecutors, Negron, along with Duran and Valera, masterminded and executed a scheme to defraud Medicare beginning in 2002 and continuing until they were arrested in October 2010. The three owners submitted false and fraudulent claims to Medicare.
American Therapeutics, the prmary vehicle for the fraud, supposedly operated what are called partial hospitalization programs in seven different locations throughout South Florida, including Boca Raton, and Orlando. A PHP is a form of intensive treatment for severe mental illness. Negron and her co-conspirators also used a related company, American Sleep Institute, to submit fraudulent Medicare claims.
Prosecutors said Negron, Duran, Valera and others paid bribes and kickbacks to operators of assisted living facilities and halfway houses and to patient brokers in exchange for delivering patients to their two companies. In some cases, the patients received a cut as well. Throughout the conspiracy, millions of dollars in kickbacks were paid in exchange for Medicare beneficiaries to attend treatment programs that were not legitimate.
Altogether, American Therapeutics and American Sleep Institute billed Medicare for more than $205 million in unnecessary or illegitimate services.
Evidence at trial also established that Negron and others altered patient files and therapist notes to make it appear that that the treatments provided were legitimate. Negron would “robo-sign” patient files as a supervising therapist without having treated the patients. The evidence also showed that Negron signed files as though she had been in two places at the same time, in Boca Raton and Homestead.
Negron also knew doctors were similarly signing patient files without reading them or seeing the patients. According to evidence presented in court, Negron even billed Medicare for group psychotherapy allegedly given to a patient who was in a vegetative state, who would not lift her head or respond. 
