Miami-Area Patient Broker Sentenced to 18 Months in Prison for Role in $200 Million Medicare Fraud Scheme

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WASHINGTON – A Miami-area patient brokerwas sentenced today to 18 months in prison for recruiting Medicarebeneficiaries as part of a $200 million Medicare fraud scheme, the Departmentof 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 SouthernDistrict of Florida.  In addition to hisprison term, Veraguas was ordered to pay $1.8 million in restitution, jointlyand severally with other co-conspirators.
 On May 30, 2012, Veraguas pleaded guilty toone count of conspiracy to commit health care fraud.  Veraguas admitted to serving as a patientbroker for American Therapeutic Corporation (ATC) and other health careagencies.  ATC operated purported partialhospitalization programs (PHPs) in seven different locations throughout SouthFlorida and Orlando. A PHP is a form of intensive treatment for severe mentalillness.
 According to court documents, Veraguasrecruited patients to attend ATC’s PHP program, among others, in exchange forillegal kickbacks.  Veraguas admittedthat based on his recruiting efforts, he caused $3.8 million in fraudulentbills to Medicare.  Veraguas admitted heknew many of the individuals he recruited did not need the treatment theypurported to have received.
 According to court filings, ATC’s owners andoperators paid millions of dollars in kickbacks to owners and operators ofassisted living facilities and halfway houses and to patient brokers inexchange for delivering ineligible patients to ATC.  According to court filings, co-conspiratorsfabricated documents in patient files to hide the fact that the patients didnot, in the first instance, qualify for treatment and did not ultimatelyreceive the treatment for which Medicare was billed.
 ATC, its management company, MedlinkProfessional Management Group Inc., and various owners, managers, doctors,therapists, patient brokers and marketers of ATC, were charged with varioushealth care fraud, kickback, money laundering and other offenses in twoindictments unsealed on Feb. 15, 2011. ATC, Medlink and more than 20 of the individual defendants charged in thesecases have pleaded guilty or have been convicted at trial.
 The sentence was announced by AssistantAttorney 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; andSpecial Agent-in-Charge Christopher Dennis of the HHS Office of InspectorGeneral (HHS-OIG), Office of Investigations Miami office.
 The criminal case is being prosecuted by TrialAttorneys Steven Kim, Robert Zink and Alan Medina of the Criminal Division’sFraud Section.  A related civil action isbeing handled by Vanessa I. Reed and Carolyn B. Tapie of the CivilDivision.  The case was investigated bythe FBI and HHS-OIG, and was brought as part of the Medicare Fraud StrikeForce, 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, theMedicare Fraud Strike Force, now operating in nine cities across the country,has charged more than 1,330 defendants who have collectively billed theMedicare program for more than $4 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, workingin conjunction with HHS-OIG, is taking steps to increase accountability anddecrease the presence of fraudulent providers.
 To learn more about the Health Care FraudPrevention and Enforcement Action Team (HEAT), go to:www.stopmedicarefraud.gov.