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Businesswoman gets 35 years in prison for Medicare scam
By Palm Beach Business.com
MIAMI — The owner of a Miami-based mental health care company has been sentenced to 35 years in prison for helping to orchestrate a scheme that took Medicare for $205 million.
Marianella Valera, the owner of American Therapeutic Corp. previously pleaded guilty to 21 counts of health care fraud, conspiracy to commit health care fraud, conspiracy to pay and receive kickbacks, money laundering and conspiracy to commit money laundering.
Federal Judge James Lawrence King also sentenced Valera, 40, to pay more than $87 million in restitution and serve three years of supervised release following her prison term. Lawrence Duran, another owner of American Therapeutic received a 50-year sentence for his role in the scheme.
Duran and Valera admitted that they began their scam as far back as 2002 and continued it until they were arrested in October 2010. ATC supposedly provided a partial hospitalization program for severely mentally ill patients. Through their company, Duran and Valera submitted false and fraudulent claims to Medicare.
According to court documents, Duran, Valera and others paid bribes and kickbacks to recruit Medicare recipients to enroll in a partial hospitalization services that were not medically necessary and in some cases not provided at all. The two business partners then used what authorities called an extensive money-laundering operation to convert Medicare payments into cash.
Duran and Valera also paid millions in kickbacks to owners of assisted living facilities and halfway houses and to patient brokers for delivering Medicare beneficiaries to their company. In some cases, the patients received a portion of those kickbacks. According to court records, the two would alter patient files and therapist notes to make it appear that they were receiving treatment from American Therapeutic. Duran and Valera also instructed employees and doctors to alter diagnoses and medication types and levels to make it appear that ATC patients qualified for partial hospitalization services.
Last month, a federal jury found Judith Negron, a third owner of American Therapeutic guilty of 24 felony counts related to the scam. Another co-conspirator, Margarita Acevedo, pleaded guilty in April.
