Claims of the Week – 866,000 of ’em

That’s how many Florida health-care exec Larry Duran took the rap for last week, as he was sentenced to 50 years in prison for Medicare fraud.

Take it away, PropertyCasualty360:

Orchestrating one of the largest Medicare cons in U.S. history, Duran submitted 866,000 dirty claims worth more than $205 million for worthless mental-health treatment. His spoils added up to $87 million.

The company, American Therapeutic Corp., was a chain of seven Florida clinics co-owned by Duran, 49, and his girlfriend, Marianella Valera, 40.

Duran bribed halfway homes, assisted-living centers and others up to $400,000 a month to funnel patients to his clinics. Doctors frequently faked records or signed off on charts without seeing any patients.

How’d he get away with it for so long? Well, his Washington lobbying efforts didn’t hurt:

He set up an advocacy group called the National Association for Behavioral Health (NABH) to convince Capitol Hill to allocate more money to him and make it easier for his clinics to operate.

In five years NABH spent more than $750,000, holding fundraisers for legislators, staging “fly-ins” on Capitol Hill and advising group members how to get around Medicare denials.


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