Lawrence Duran and his girlfriend Marianella Valera face sentencing on Wednesday for a scheme which cost Medicare $205 million.  Duran, Valera, and others operated American Therapeutic, a company that provided kickbacks for referrals to its group therapy services.  Those who received kickbacks referred thousands of Medicare patients to American Therapeutic’s services, including many who suffered from dementia and Alzheimer’s and who clearly could not benefit from such services.  In order to make these patients and others appear qualified to receive American Therapeutic services, Duran and others falsified patient records at “charting parties.”

Prosecutors are asking that Duran receive a 50 year sentence and his girlfriend a 40 year sentence for their role in orchestrating this scheme.  Duran’s actions are particularly culpable, according to prosecutors, because of his advocacy on behalf of the National Association for Behavioral Health, an organization the government alleges lent apparent legitimacy to Duran’s claims.  In addition to lobbying against cuts to mental health clinics–including Duran’s–the Association provided Duran a vehicle to distribute information to other community mental health centers on how to overcome Medicare denials of claims.

If Duran is sentenced to 50 years, it will be the longest sentence ever imposed for Medicare fraud.

Read the entire article, “Miami couple faces lengthy sentence for Medicare fraud”