WASHINGTON – A Miami-area resident pleaded guilty today in U.S. District Court in Miami for her role in managing a community mental health care fraud scheme that resulted in the submission of more than $100 million in fraudulent claims to Medicare, the Departments of Justice and Health and Human Services (HHS) announced.
Margarita Acevedo pleaded guilty before U.S. Magistrate Judge Barry L. Garber to one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive illegal health care kickbacks. In pleading guilty, Acevedo admitted that since 2005, she served as the marketing director for American Therapeutic Corporation (ATC), a Florida corporation headquartered in Miami that operated purported partial hospitalization programs (PHPs) in seven different locations throughout South Florida and Orlando. A PHP is a form of intensive treatment for mental illness.
Acevedo admitted that as marketing director, her job was to orchestrate the payment of kickbacks and bribes used to recruit Medicare beneficiaries to attend ATC and a related company, American Sleep Institute (ASI). Acevedo admitted that the Medicare beneficiaries recruited by ATC and ASI, were not eligible to receive the PHP and sleep study services that ATC and ASI billed to Medicare, and that the services were not medically necessary. During the period of her involvement in the fraud scheme, the defendant admitted that she and her co-conspirators caused between $100 million and $200 million in fraudulent claims to be submitted to Medicare for services purportedly provided at ATC and ASI.
According to court documents, Acevedo and others paid kickbacks to owners and operators of assisted living facilities (ALFs) and halfway houses and to patient brokers in exchange for providing ineligible patients to ATC and ASI. Acevedo and her co-conspirators knew that Medicare beneficiaries were recruited regardless of their medical needs and in some cases the beneficiaries received a portion of the kickbacks. Acevedo and her co-conspirators actively recruited ALF and halfway house owners and operators and patient brokers to participate in this kickback scheme. Acevedo admitted that she and other co-conspirators paid and caused the payment of millions of dollars in kickbacks in exchange for Medicare beneficiaries to attend ATC and ASI programs for which they did not qualify so that ATC and ASI could bill Medicare for medically unnecessary services.
Acevedo also admitted that she and her co-conspirators engaged in elaborate and sophisticated measures to conceal their fraudulent activities from Medicare and from law enforcement.
Acevedo and her co-conspirators were charged in a superseding indictment unsealed on Feb. 15, 2011. The superseding indictment alleges that ATC and ASI submitted a total of more than $200 million in claims to Medicare.
Friday, April 8, 2011
Margarita Acevedo Pleads Guilty for Her Role in Community Mental Health Care Fraud Scheme Involving More Than $100 Million in Fraudulent Medicare Claims
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