Two Charged in a $190 Million Miami Medicare Fraud Scheme By Tod Aronovitz | 10/02/13 | 0 Comment

Two additional Miami-area residents were indicted in connection with their alleged role in a $190 million Medicare fraud case that that has already produced numerous convictions and prison sentences for those involved in the plot.

Mayelin Santoyo, 28, and Jose Martin Olivares, 36, were each charged with one count of conspiracy to defraud the United States and to receive illegal health care kickbacks, and two counts of receiving health care kickbacks. If convicted, they each face a maximum penalty of five years in prison for every charge.

According to federal prosecutors, Santoyo and Olivares served as patient brokers in an alleged scheme orchestrated by the owners and operators of American Therapeutic Corporation (ATC) and its management company, Medlink Professional Management Group Inc., in Miami. ATC operated purported partial hospitalization programs (PHPs) in seven locations throughout South Florida and Orlando.

The pair is accused of having provided ineligible PHP patients to ATC in exchange for millions of dollars in kickbacks. According to the indictment, the amount of the kickback was based on the number of days each recruited patient spent at ATC.

Throughout the course of the conspiracy, from about February 2006 to October 2010, ATC billed Medicare using the recruited Medicare beneficiaries who did not qualify for PHP services and who attended treatment programs that were not legitimate. The co-conspirators then laundered Medicare reimbursements to get enough cash to support the kickbacks.

ATC, Medlink, and its various owners, managers, doctors, therapists, patient brokers and marketers have since pleaded guilty or been convicted at trial. In September 2011, ATC owner Lawrence Duran was sentenced to 50 years in prison for his prominent role in the fraud case. Both corporations are now defunct.

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.