Miami-Area Patient Broker Sentenced to 18 Months in Prison for Role in $200 Million Medicare Fraud Scheme
A Miami-area patient broker was sentenced yesterday to 18 months in prison for recruiting Medicare beneficiaries as part of a $200 million Medicare fraud scheme, the Department of Justice, FBI and Department of Health and Human Services announced.
Jean-Luc Veraguas, 51, of Plantation, Fla., was sentenced by U.S. District Judge Frederico A. Moreno in the Southern District of Florida. In addition to his prison term, Veraguas was ordered to pay $1.8 million in restitution, jointly and severally with other co-conspirators.
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) in seven different locations throughout South Florida and Orlando. A PHP is a form of intensive treatment for severe mental illness.
According to court documents, Veraguas recruited patients to attend ATC's PHP program, among others, in exchange for illegal kickbacks. Veraguas admitted that based on his recruiting efforts, he caused $3.8 million in fraudulent bills to Medicare. Veraguas admitted he knew many of the individuals he recruited did not need the treatment they purported to have received.
According to court filings, ATC's owners and operators paid millions of dollars in kickbacks to owners and operators of assisted living facilities and halfway houses and to patient brokers in exchange for delivering ineligible patients to ATC. According to court filings, co-conspirators fabricated documents in patient files to hide the fact that the patients did not, in the first instance, qualify for treatment and did not ultimately 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.
The sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department's Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Jeffrey C. Mazanec, Acting Special Agent-in-Charge of the FBI's Miami Field Office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.
The criminal case is being prosecuted by Trial Attorneys Steven Kim, Robert Zink and Alan Medina of the Criminal Division's Fraud Section. A related civil action is being handled by Vanessa I. Reed and Carolyn B. Tapie of the Civil Division. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Southern District of Florida.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,330 defendants who have collectively billed the Medicare program for more than $4 billion. In addition, HHS's Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov .