Miami ~ Thursday, October 21, 2010
Good morning. And thank you, Willy, for that introduction and for your continued support for our joint efforts to fight Medicare fraud in South Florida.
Today we are announcing the latest efforts by the Health Care Fraud Prevention and Enforcement Action Team – or HEAT – to combat Medicare fraud. Four individuals were arrested this morning for their alleged roles in an unprecedented scheme to defraud the Medicare program of tens of millions of dollars. These individuals are the owners and senior managers of American Therapeutic Corporation, or ATC, and Medlink Professional Management Group, Inc. – two businesses that were used to perpetrate the fraud scheme. Along with the four individuals, ATC and Medlink have been charged in a 13-count indictment that was unsealed today in U.S. District Court here in Miami.
Today’s charges mark the first time that HEAT’s Medicare Fraud Strike Force has indicted a corporate entity for Medicare fraud. Indeed, as described in the indictment, the defrauding of Medicare was the business model for ATC and Medlink. From its seven locations throughout the Miami area, ATC, together with the other charged defendants, allegedly submitted to Medicare close to $200 million in billing – much, if not all, of which was fraudulent. This represents the largest fraudulent billing scheme ever prosecuted by the Strike Force. Criminal forfeiture charges have also been unsealed today against ATC and many of the other defendants – charges that will allow us to seek to recover all of the money they allegedly stole from Medicare.
The details of the fraud scheme, as set out in the indictment, are striking. Sadly, we’ve seen far too many individuals bill Medicare for medical equipment and services that were either unnecessary or never provided. But the alleged illegal conduct charged in this indictment is, in many respects, unlike anything we’ve seen before in terms of the nature and size of the scheme. As alleged in the indictment, ATC and the other defendants preyed on some of the most vulnerable patients, paying kickbacks to owners and operators of assisted living facilities and halfway houses in exchange for patient referrals to ATC. At ATC locations, bogus mental health "therapy sessions" were organized, where elderly and infirm patients were left in rooms for hours, with no legitimate or medically necessary therapy being performed. Some of the patients suffered from Alzheimer’s disease, or dementia, and were not even cognizant of where they were. Other patients were simply there to make money, through kickbacks. The indictment alleges that the defendants then fraudulently billed Medicare, falsely claiming the patients were part of a legitimate partial hospitalization program and receiving intensive mental health treatment.
Several of the defendants are also charged with holding so-called "charting parties," where senior managers of ATC met routinely to falsify patient medical charts. Medication types, medication levels, and patient diagnoses were fabricated – all in an alleged effort to make it look like patients were receiving legitimate mental health treatment, when nothing could be further from the truth.
Medicare fraud, whether in South Florida, Detroit, Brooklyn, or elsewhere in the country, simply won’t be tolerated – not by taxpayers, not by this Administration, and not by our agents and prosecutors. When criminals innovate and find new ways to cheat the system, Strike Force investigators and prosecutors are there to find them and prosecute them. And in appropriate cases, if corporations are used to carry out those schemes, we will take action against them too.
Our Strike Force operations are continuing to yield tremendous results. Just three months ago, right here in Miami, Attorney General Holder and Secretary Sebelius announced charges against 94 individuals throughout the country for Medicare fraud – the largest takedown by Strike Force operations to date. Since its inception in 2007, Strike Force operations have led to charges against more than 825 defendants who falsely billed the Medicare program more than $2 billion.
And our partners in the Civil Division are employing critically important civil tools to combat health care fraud in the United States. I’m delighted that Tony West, the Assistant Attorney General of the Civil Division, could be here with us today to talk about those efforts and about the Civil Division’s important role in this case. I’ll now turn it over to Tony.