Reporting CBSMiami.com Team
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South Florida Crime
MIAMI (CBSMiami) — A 51-year-old Plantation man was sentenced Monday to 18 months in prison for recruiting Medicare beneficiaries as part of a $200 million Medicare fraud scheme, reported the FBI and other federal agencies.
In addition to his prison term, Jean-Luc Veraguas and his co-conspirators were ordered to pay $1.8 million in restitution.
On May 30, 2012, Veraguas pleaded guilty to one count of conspiracy to commit health care fraud.
Veraguas admitted to serving as a patient broker for American Therapeutic Corporation (ATC) and other health care agencies. ATC operated purported partial hospitalization programs (PHPs), which offer intensive treatment for severe mental illness to patients in need.
These PHPs operated in seven locations throughout South Florida and Orlando.
According to court documents, Veraguas recruited patients to attend ATC’s PHP program, among others, in exchange for illegal kickbacks. Veraguas admitted that his recruiting efforts resulted in $3.8 million in fraudulent bills to Medicare.
He also admitted he knew many of his recruits did not need the treatment they received.
ATC’s administrators paid millions in kickbacks to owners and operators of assisted living facilities, halfway houses, patient brokers. In exchange for the money, ATC would receive these ineligible patients.
The court documents reveal co-conspirators fabricated documents in patient files to hide the fact that the patients did not, in the first instance, qualify for treatment.
Also not hid in the fabricated documents: the patients ultimately did not receive the treatment for which Medicare was billed.
ATC, its management company, Medlink Professional Management Group Inc., and various owners, managers, doctors, therapists, patient brokers and marketers of ATC, were charged with various health care fraud, kickback, money laundering and other offenses in two indictments unsealed on Feb. 15, 2011.
ATC, Medlink and more than 20 of the individual defendants charged in these cases have pleaded guilty or have been convicted at trial.
This case was brought as part of the Medicare Fraud Strike Force, which operates in nine cities across the country.
Since its inception in March 2007, it has charged more than 1,330 defendants who have collectively billed the Medicare program for more than $4 billion.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.