Miami health-care executive Larry Duran orchestrated one of the largest Medicare frauds in U.S. history, submitting more than $205 million in phony claims and landing a record-breaking 50-year prison sentence for his crimes.
But another piece of Duran’s scheme also caught the eye of prosecutors. They say he extended his fraud through his lobbying efforts, all aimed at getting official Washington to make it easier for mental health centers such as his to make money.
An advocacy group he helped set up, the National Association for Behavioral Health (NABH), has spent more than $750,000 on lobbying efforts over the past five years, including staging “fly-ins” on Capitol Hill and providing advice to group members on how to get around Medicare denials, according to the Justice Department. The group also held fundraisers for lawmakers such as Sen. Mary Landrieu (D-La.) and former congressman Kendrick B. Meek (D-Fla.), records show.
“Duran did not stop with just committing a massive fraud on the Medicare program through his own companies. Duran franchised his fraud to others,” trial lawyer Jennifer Saulino wrote in a sentencing memo. The advocacy group he helped found, she said, “provided Duran a legitimate-looking vehicle to lobby Congress to allocate more money, through Medicare, to Duran and his co-conspirators for their fraudulent schemes.”
The case has alarmed advocates and providers in the mental health field who fear that Duran’s illicit operation — and his related lobbying efforts — will undermine the legitimate needs of poor patients struggling with psychiatric problems. It comes amid a widening crackdown by the Justice Department on fraud within Medicare, the government’s health-care program for the elderly and disabled, and Medicaid, which serves the poor.
Duran said he pleaded guilty in the case to atone for his actions.
“I am sorry, and I have been for years,” he testified at his sentencing hearing Sept. 16. “Not that day that I was arrested, but for years and years. I had to live with all of this for a very long time.”
The company at the center of the case, American Therapeutic Corp., was a chain of seven Florida clinics co-owned by Duran, 49, and his girlfriend, Marianella Valera, 40. The firm made an estimated 866,000 bogus claims and received $87 million in fraudulent Medicare fees, laundering much of the money through an elaborate system of shell companies, according to Duran’s guilty plea.
The basic scheme, records show, worked like this: Duran and Valera paid up to $400,000 a month in kickbacks to assisted living centers, halfway homes and others to procure a steady stream of patients for their clinics, which claimed to be providing group mental health treatment. Doctors frequently faked records or signed off on charts without seeing any patients.
Patients often suffered from Alzheimer’s disease, dementia or other conditions unsuited for therapy and were frequently left to urinate or defecate on themselves as they waited for treatment that never came, testimony showed.
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