Dive Brief:
- Damien Mayol, president of Miami-based Transportation Services Providers, will serve five years in prison for his part in a $70 million healthcare fraud scheme with three additional co-conspirators. Mayol will also have to pay $27 million in restitution.
- The scheme involved three mental health clinics in the Miami area that Mayol and others used to develop an illegal kickback operation where recruiters were paid for referring patients to those clinics.
- The three clinics, which served Medicare beneficiaries, submitted more than $70 million in false claims between January 2008 and December 2010, according to the U.S. Attorney's Office for the Southern District of Florida.
Dive Insight:
The three other people involved in the fraud scheme pleaded guilty this past October and received prison terms ranging from two to 10 years, according to the Department of Justice. They were employed at the three mental health clinics; one was an owner, one a clinical director, and the other a therapist.
All three submitted false Medicare claims and offered and paid kickbacks and bribed to patient recruiters in exchange for Medicare referrals, according to the South Florida Business Journal. Two of the co-conspirators also falsified or altered patient documents so it appeared the Medicare beneficiary required services, when in fact, these services were not medically necessary.
A national Medicare fraud sweep last year resulted in charges against 243 individuals for alleged participation in Medicare fraud schemes totalling $712 million in false billings, according to the Department of Health and Human Services (HHS).