Owner of Miami Assisted Living Facility Sentenced to 15 Months in Prison for Role in Medicare Fraud Conspiracy
|U.S. Department of Justice November 05, 2012|
WASHINGTON—The owner of a Miami-Dade County assisted living facility (ALF) was sentenced today to 15 months in prison for her role in a kickback scheme that funneled ALF patients to fraudulent mental health providers American Therapeutic Corporation (ATC) and Health Care Solutions Network (HCSN), announced 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; Michael B. Steinbach, Acting Special Agent in Charge of the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations, Miami Office.
Alba Serrano, 66, of Miami, was sentenced today by U.S. District Judge Patricia A. Seitz in the Southern District of Florida. In addition to her prison term, Serrano was sentenced to serve three years of supervised release and ordered to pay $258,329 in restitution.
On June 6, 2012, Serrano pleaded guilty in Miami to one count of conspiracy to commit health care fraud.
According to court documents, Serrano was the owner of Elsa’s House, an ALF that she operated for more than two decades in South Miami. Serrano pleaded guilty to sending Medicare beneficiaries who resided at Elsa’s House to both ATC and HCSN for partial hospitalization program (PHP) services, a form of intensive treatment for severe mental illness, in exchange for illegal health care kickbacks. In her plea agreement, Serrano admitted that she referred beneficiaries to both ATC and HCSN in exchange for cash kickbacks, even though she knew that some of the beneficiaries did not suffer from severe mental illness and accepting health care kickbacks was illegal.
According to the plea agreement, Serrano’s participation in the fraud resulted in at least $591,385 in fraudulent billing to the Medicare program.
In related cases, 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 in February 2011. ATC, Medlink, and more than 20 of the individual defendants charged in these cases have pleaded guilty or have been convicted at trial.
An indictment unsealed on May 2, 2012, charged nine defendants for their alleged roles in the HCSN health care fraud scheme. Four defendants have pleaded guilty, and five defendants are scheduled for trial on January 14, 2013, before U.S. District Judge Cecilia M. Altonaga in Miami. Defendants are presumed innocent until proven guilty at trial.
The case is being prosecuted by Trial Attorney William Parente of the Criminal Division’s Fraud Section. 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 1,480 defendants who have collectively billed the Medicare program for more than $4.8 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.