Lawmakers, investigators and judges are pushing harder than ever to show that they are dedicated to punishing people convicted of health care fraud. The latest example involved a health care executive in Miami who was sentenced to 50 years in federal prison for Medicare fraud. The sentence is 20 years longer than any other sentence given in connection to Medicare fraud. The judge made it clear that it was his intent to provide a deterrent against healthcare fraud in South Florida, an area long regarded as the primary hot spot for fraudulent Medicare claims.

The Miami man was co-owner of a large mental health company that specialized in treating the victims of addiction, dementia and Alzheimer’s disease. Over the years, the company submitted $205 million in fraudulent Medicare claims and received payments totaling $87 million. The claims were for expensive group therapy sessions that either were not provided or were not needed.

The case involved charges against 34 people at American Therapeutic Corp. The Miami man and his girlfriend were both charged as co-owners of the company. In addition, doctors, therapists, nurses, employees and others are facing criminal penalties for their roles in the improper Medicare claims. In many cases, recruiters were paid kickbacks to provide the steady stream of “patients” needed to file Medicare claims. A former employee of the company reported the improper conduct as part of a civil case in 2007.

The sentence, while exceptional, may be just the beginning for those accused of health care fraud. In the face of political and media pressure, those charged with catching and punishing white collar criminals have become much more aggressive. Anyone charged with a health care crime can expect to be prosecuted to the fullest extent of the law.

Source: The Miami Herald, “Judge sends Medicare offender to prison for 50 years,” Jay Weaver, 17 September 2011

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