Two Florida-based companies, Medlink Professional Management Group and American Therapeutic Corp., entered guilty pleas in U.S. District Court on Tuesday. The charges stemmed from a Medicare fraud scheme that resulted in more than $200 million in improper claims.

The sentencing phase, which is scheduled for July, could lead to fines in excess of $80 million. Executives and other professionals who participated in the health care fraud face extensive fines and potentially lengthy prison sentences. Several executives have already pled guilty in connection with the incident.

In this case, ATC and Medlink worked together to alter patient files and the findings of treating therapists to make it look like the patients qualified for treatments offered by ATC. Company employees and doctors were instructed to make specific diagnoses and order certain medications to allow the company to make Medicare claims. In addition, assisted living facilities, halfway houses, patient brokers and in some cases the patients themselves were paid kickbacks to help ATC make claims for patients who were actually ineligible for Medicare assistance.

The clinics involved were raided by law enforcement officials as part of the government’s Medicare Fraud Strike Force. To date, this action has led to more than 1,000 arrests involving Medicare claims totaling more than $2 billion dollars. Each claim to Medicare may involve a number of health care and business professionals. The Department of Justice is aggressively pursuing these claims and has stepped up enforcement actions regarding all forms of health care fraud.

Source: South Florida Business Journal, “Miami corporations plead guilty in Medicare fraud,” 4 May 2011

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