The following excerpt is from the Department of Justice website:
Thursday, November 17, 2011
Fort Lauderdale, Fla.-Area Assisted Living Facility Manager Pleads Guilty to Fraud and Kickback Scheme
WASHINGTON – The manager of a Fort Lauderdale, Fla.-area assisted living facility and owner of a purported community mental health center pleaded guilty yesterday for his role in a Medicare fraud kickback scheme that funneled patients through a fraudulent mental health company, American Therapeutic Corporation (ATC), announced the Department of Justice, FBI and Department of Health and Human Services (HHS).
Ramchand Ramrup, aka Ramy Ramrup, 35, pleaded guilty before U.S. District Judge Marcia G. Cooke in Miami to one count of conspiracy to commit health care fraud. Ramrup was the manager and operator of Boynton Beach Assisted Living Facility (BBALF) and the owner of a purported community mental health center called Florida Behavioral Specialists Inc.
Ramrup admitted that in exchange for illegal health care kickbacks, he agreed to provide Medicare beneficiaries who resided at BBALF to ATC for intensive mental health treatment called partial hospitalization program (PHP) services. ATC purported to operate PHPs in seven different locations throughout south Florida and Orlando. According to court documents, Ramrup was paid approximately $40 per Medicare beneficiary per day the beneficiary attended ATC for purported PHP treatment. ATC paid the kickbacks by check made out to Florida Behavioral Specialists Inc.
According to court documents, Ramrup knew that ATC would fraudulently bill Medicare for the PHP treatment that his referrals would purportedly receive at ATC. Ramrup admitted that he did not refer beneficiaries to ATC because a physician had ordered PHP treatment. He referred beneficiaries to ATC because, among other things, he would receive kickbacks, his referrals were covered by Medicare and they were willing to attend ATC.
According to court filings, ATC’s owners and operators paid kickbacks to owners and operators of assisted living facilities and halfway houses and to patient brokers in exchange for delivering ineligible patients to ATC and its related company, the American Sleep Institute (ASI). In some cases, the patients received a portion of those kickbacks. Throughout the course of the ATC conspiracy, millions of dollars in kickbacks were paid in exchange for Medicare beneficiaries who did not qualify for PHP services. The ineligible beneficiaries attended treatment programs that were not legitimate so that ATC and ASI could bill Medicare more than $200 million in medically unnecessary services.
According to the plea agreement, Ramrup’s participation in the fraud resulted in more than $873,200 in fraudulent billing to the Medicare program. At sentencing, scheduled for Feb. 8, 2012, Ramrup faces a maximum of 10 years in prison and a $250,000 fine.
ATC, its management company Medlink Professional Management Group Inc., and various owners, managers, doctors, therapists, patient brokers and marketers of ATC, Medlink and ASI, were charged with various health care fraud, kickback, money laundering and other offenses in two indictments unsealed on Feb. 15, 2011. ATC, Medlink and nine of the individual defendants have pleaded guilty or have been convicted at trial. Other defendants are scheduled for trial April 9, 2012, before U.S. District Judge Patricia A. Seitz.
The guilty plea was announced by 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; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher B. Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.
The case is being prosecuted by Trial Attorneys Steven Kim and Jennifer L. Saulino 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 operations in nine locations have charged more than 1,140 defendants that collectively have billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.”
