Two South Florida doctors, 3 others convicted on Medicare fraud charges
A Miami federal jury convicted five people of Medicare-related fraud in a case involving the nation’s biggest mental-health racket.
By Jay Weaver
Two South Florida doctors stared in disbelief — then teared up as they turned to relatives for comfort — after a federal jury found them guilty Friday of conspiring to defraud Medicare through the nation’s biggest mental-health racket.
The 12-person Miami jury convicted psychiatrists Mark Willner of Weston and Alberto Ayala of Coral Gables, the medical directors for American Therapeutic Corp., for their roles in a $205 million scheme to fleece the taxpayer-funded program for the elderly and disabled. The jurors found them not guilty on other healthcare fraud offenses.
In addition, the jury convicted Vanja Abreu, Ph.D, program director for American Therapeutic in Miami-Dade, of the same healthcare-fraud conspiracy offense, and two other defendants, Hilario Morris and Curtis Gates, of paying kickbacks to residential home operators in exchange for providing patients.
However, the jurors, who deliberated for five days after a nearly two-month trial, could not reach conspiracy verdicts against Lydia Ward, Ph.D., program director for American Therapeutic in Broward, Nichole Eckert, a Fort Lauderdale therapist, or Morris and Gates. Justice Department lawyers said they plan to retry those defendants on the deadlocked counts.
“I think the jury was deeply divided,” said Ward’s attorney Dennis Urbano, who noted the panel went through three forepersons and that two jurors asked to be dismissed after deliberations began May 25. “It shows there was a lot of conflict.’’
After the verdicts, U.S. District Judge Patricia Seitz revoked the bonds of the two doctors and Morris, who will remain in custody at the Federal Detention Center until they are sentenced in August. The doctors and Abreu face up to 10 years in prison. Morris and Gates face up to five years.
Seitz said she was concerned that the doctors and Morris might flee the country, despite arguments by their lawyers that they have “strong ties” to the South Florida community. “There has been a verdict,” the judge said. “It’s a lot more than a possibility.”
Since Miami-based American Therapeutic’s clinic chain was shuttered nearly two years ago, 35 defendants have been charged in the case with the majority pleading guilty. Last year, a third doctor, psychiatrist Alan Gumer of Tamarac, pleaded guilty, accepting responsibility for more than $19 million of false claims submitted by the clinics.
Gumer testified against fellow doctors Willner and Ayala, who were accused of altering the diagnoses and medications of thousands of patients to make it look as if they qualified for group therapy sessions so that Medicare would pay fraudulent bills submitted by American Therapeutic.
‘DOESN’T MAKE SENSE’
Justice Department trial attorney Jennifer Saulino said the doctors’ assertions that they were unaware of the fraud while prescribing $120 million worth of psychotherapy sessions at the chain of clinics “does not make sense.” Willner and Ayala were paid $641,000 and $536,000, respectively, for their services, according to trial evidence.
The prosecutor said all seven defendants not only victimized Medicare, but also the chain’s patients. Among them: people with Alzheimer’s disease, addicts and alcoholics, bused from assisted-living facilities to the chain’s six clinics in Miami-Dade, Broward and Palm Beach counties.
Saulino said the costly group therapy sessions were intended for patients with schizophrenia, bipolar conditions and other severe mental illnesses. “Those are the victims who were used to commit this fraud,” she said during closing arguments a week ago.
But a defense attorney for Eckert, American Therapeutic’s therapist in Broward, said she had no clue about any corruption in the company as she counseled patients. “God bless America,” her lawyer, Michael Tein, said after the jury hung on her conspiracy charge and acquitted her on healthcare-fraud offenses. “The system worked.”
Defense attorneys for the two doctors sought to portray the physicians as victims themselves who were kept in the dark by American Therapeutic’s top executives, including owner Lawrence Duran, now serving a 50-year prison sentence. Duran and three other convicted execs pocketed $83 million from Medicare during the past decade.
Attorney Sam Rabin, who represents Willner, tried to show jurors that he worked only part time at two Broward clinics for American Therapeutic, visiting the sites once or twice a week as he interacted with his team of psychiatric nurses.
Ayala’s defense lawyer, Jose Quiñon, also said his client worked part time at American Therapeutic’s clinic in Miami and Homestead, visiting the facilities once a week and relying on a physician’s assistant.
Seitz, the judge, limited their legal strategy by ruling that the two defense attorneys could not try to show that Willner and Ayala were following state law when they relied on other professionals to determine patient diagnoses. Said Rabin: “We will be appealing.”