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Another Guilty Plea in Medicare Fraud Case

The fallout from the American Therapeutic Corp. case continued today as a Miami woman entered a guilty plea in federal court. The $200 million Medicare fraud case has led to 20 indictments of doctors, administrators, executives and others in South Florida. Ten criminal defendants have already entered guilty pleas or been found guilty at trial. The rest have been scheduled for trial in April.

In the guilty plea, the woman admitted to soliciting beneficiaries, paying kickbacks and marketing the sleep services provided by ATC. She is facing a prison sentence of up to 15 years, as well as a $250,000 fine if the judge decides to impose the maximum penalty. The woman will be sentenced in June for her role in the scheme.

In addition to the ATC related activity, the woman acknowledged playing a role in another Medicare fraud scheme with a Miami home health agency. The agency submitted false Medicare claims to the tune of $46 million. She played a similar role for that company by finding Medicare eligible people who would claim to receive these services in exchange for a kickback.

Federal prosecutors are aggressively pursuing Medicare fraud cases in 2012. This continues a nationwide effort to reduce the cost of the Medicare program which can be attributed to improper billing. Anyone found to be involved in questionable practices surrounding the health care program should expect to be prosecuted and face serious criminal penalties.

Source: South Florida Business Journal, "Miami woman pleads guilty in $200M Medicare fraud," by Susan R. Miller, 18 January 2012

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