Owners and Operators of Physical Therapy Clinics Charged in Multi- Million Dollar Health Care Fraud Conspiracy
Tampa, Florida - United States Attorney Robert E. O'Neill announces the unsealing of a thirty-count indictment charging Luis Duluc (51, formerly of Weston, Florida), and Margarita Grishkoff (57, Charlotte, North Carolina) with conspiracy to commit health care fraud, and additional substantive counts of health care fraud, making false statements related to a health care matter, and aggravated identity theft. If convicted, Duluc and Grishkoff each face a maximum penalty of ten years in federal prison for the conspiracy charge; ten years for each health care fraud charge (19 counts); five years for each false statement charge (6 counts), along with a mandatory minimum term of two years in federal prison for the aggravated identity theft charges (4 counts). The indictment also notifies Duluc and Grishkoff that the United States is seeking a money judgment in the amount of $8,152,262.14, which constitutes the proceeds of their alleged health care fraud conspiracy.
According to the indictment, between June 2005 and April 2008, Duluc and Grishkoff utilized multiple physical therapy clinics to fraudulently bill Medicare for services not rendered to any Medicare beneficiaries. During the time frame of the conspiracy, Duluc and Grishkoff, through their holding company, Ulysses Acquisitions, Inc., purchased three physical therapy clinics in the Middle District of Florida - including: West Coast Rehabilitation, Inc. (Fort Myers); Rehab Dynamics, Inc. (Venice); and Polk Rehabilitation, Inc. (Lake Wales). These clinics were used by Duluc and Grishkoff to fraudulently bill Medicare.
As alleged in the indictment, there were several facets to this conspiracy. First, Duluc and Grishkoff paid patient recruiters to acquire Medicare beneficiary information for purposes of falsely billing Medicare. In addition, upon acquisition of their physical therapy clinics, they also acquired the historical patient records left at the clinic sites, including the names and identification numbers of Medicare beneficiaries. As a part of their scheme to defraud Medicare, Duluc and Grishkoff used this Medicare beneficiary information to fraudulently bill Medicare.
Second, Duluc and Grishkoff allegedly allowed others, who owned and operated similarly illegitimate physical therapy clinics in the Southern and Middle Districts of Florida, to use Duluc’s and Grishkoff’s clinics to submit fraudulent claims for reimbursement to Medicare. This was known by the conspirators as the 80/20 or 85/15 deal. Based on their arrangement, Duluc and Grishkoff accepted bogus patient records and billing forms from the co-conspirator clinics and billed Medicare for services as if they had been provided by Duluc's and Grishkoff's clinics. The Medicare fraud proceeds were generally split 80/20 by the parties, with 80% going to the co-conspirator clinics and 20% being kept by Duluc’s and Grishkoff's clinics.
The indictment alleges that, as a result of Duluc’s and Grishkoff's health care fraud scheme, Medicare paid out approximately $8,152,262.14 for services not rendered.
An indictment is merely a formal charge that a defendant has committed a violation of the federal criminal laws, and every defendant is presumed innocent unless, and until, proven guilty.
This case was investigated by the Department of Health and Human Services, Office of Inspector General, and the Defense Criminal Investigative Service. It will be prosecuted by Assistant United States Attorney Simon Gaugush.