Health-care executive Larry Duran broke a record, but it's not one for the Guinness books.
He was sentenced to 50 years in prison – the longest prison term ever imposed for Medicare fraud.
Orchestrating one of the largest Medicare cons in U.S. history, Duran submitted 866,000 dirty claims worth more than $205 million for worthless mental-health treatment. His spoils added up to $87 million.
The company, American Therapeutic Corp., was a chain of seven Florida clinics co-owned by Duran, 49, and his girlfriend, Marianella Valera, 40.
Duran bribed halfway homes, assisted-living centers and others up to $400,000 a month to funnel patients to his clinics. Doctors frequently faked records or signed off on charts without seeing any patients.
Patients, suffering from Alzheimer's, dementia or other conditions unsuited for therapy, were often left to urinate or defecate on themselves while waiting for treatment that never came.
"The people that were there were just kept there and run through like cattle," the judge in the case said.
Duran kept on, even going as far to deceive Congress. He set up an advocacy group called the National Association for Behavioral Health (NABH) to convince Capitol Hill to allocate more money to him and make it easier for his clinics to operate.
In five years NABH spent more than $750,000, holding fundraisers for legislators, staging "fly-ins" on Capitol Hill and advising group members how to get around Medicare denials.
Mental-health advocates said this case has been detrimental to legitimate providers, many of which are nonprofits that rely heavily on federal support.
"To have them involved in fraud like this is horrendous," National Council on Community Behavioral Healthcare President Linda Rosenberg said. "It hurts people with mental-health issues and their families. Everyone gets tainted when something like this happens."
Duran said he pleaded guilty because he feels remorseful. The court appeared unmoved.
Valera was sentenced to 35 years for her role, and a total of 34 people, including employees of American Therapeutic, doctors, and nurses, were arrested in connection with the scheme.
Source: Zalma's Insurance Fraud Letter and The Washington Post
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