Physical Therapy Clinic Owner Pleads Guilty in $28.3 Million Health Care Fraud By Tod Aronovitz | 02/24/14 | 0 Comment

Luis Duluc, the owner and operator of several physical therapy rehabilitation facilities throughout Florida, pleaded guilty to conspiracy to commit health care fraud and making a false statement relating to health care matters, a Department of Justice news release recently announced. The 53-year old southwest Florida man coordinated and led a $28.3 million Medicare fraud scheme that involved physical and occupational therapy clinics and other business entities to submit fraudulent Medicare claims.

According to court documents, approximately $28,347,065 in health care fraud claims were made to Medicare from 2005 through 2009. The claims sought reimbursement for therapy services that were not legitimately prescribed and not actually provided. Medicare paid approximately $14,424,865 on those claims.

At the time, Duluc was chairman and president Ulysses Acquisitions, a Delaware holding company that purchased comprehensive outpatient rehabilitation facilities (CORFs) and outpatient physical therapy providers (OPTs) for the purpose of getting control of these clinics’ Medicare provider numbers. Working with co-conspirators in Miami and elsewhere, Duluc also obtained identifying information of Medicare beneficiaries and unique identifying information of physicians by paying kickbacks and stealing the information.

The information was then used to create false and forged patient records to make fraudulent claims to Medicare through the clinics that Ulysses Acquisitions bought. These clinics included: West Coast Rehab Inc. in Fort Myers, Rehab Dynamics Inc. in Venice, Polk Rehabilitation Inc. in Lake Wales, and Renew Therapy Center of Port St. Lucie LLC.

Another part of the conspiracy was the “80/20 Deal”—a deal that Duluc developed and promoted involving substantial kickbacks to co-conspirators who owned other therapy clinics to broaden the overall fraud scheme.

For example, Duluc and co-conspirators would use the clinics they controlled to submit false reimbursement claims to Medicare on behalf of other Miami-based therapy clinics such as Hallandale Rehabilitation Inc., Tropical Physical Therapy Corporation, American Wellness Centers Inc., and West Regional Center Inc. As part of the deal, Duluc and co-conspirators would keep approximately 20 percent of the money Medicare paid on these health care fraud claims and pay the other 80 percent to the co-conspirator clinic owners.

Finally, to distance himself from the fraudulent operations, Duluc sold the clinics owned by Ulysses Acquisitions when he was finished with them.  The sham sales were made to nominee or straw owners, who were all recent immigrants with no background or experience in the health care industry.

Duluc, whose sentencing date will be set by the court, faces a maximum penalty of 15 years in prison.

How to Report Miami Medicare Fraud

Healthcare or medical billing employees who have inside knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami Qui Tam law firm of ARONOVITZ LAW routinely works with Miami whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / Qui Tam lawyer Tod Aronovitz to discuss a case.