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Friday, March 25, 2016

President of Miami-Based Transportation Company Sentenced to 60 Months in Prison for Role in $70 Million Health Care Fraud Scheme

The president of a transportation company based in Miami was sentenced today to 60 months in prison for his role in a health care fraud scheme involving three mental health centers that resulted in the submission of approximately $70 million in false and fraudulent claims to Medicare.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida and Special Agent in Charge George L. Piro of the FBI’s Miami Division made the announcement.

Damian Mayol, 45, of Miami, was sentenced by U.S. District Judge Ursula Ungaro of the Southern District of Florida, who also ordered Mayol to pay $26,808,841 in restitution and to forfeit the same amount.  In January 2016, Mayol was convicted of conspiracy to pay health care kickbacks after a five-day trial.

According to evidence presented at trial, Mayol was the president of Transportation Services Providers Inc. and, along with his co-conspirators, used the company to coordinate the payment of illegal health care kickbacks to recruiters, who in return referred patients to three now-defunct clinics in the Miami area: R&S Community Mental Health Inc. (R&S), St. Theresa Community Mental Health Center Inc. (St. Theresa) and New Day Community Mental Health Center LLC (New Day). 

The evidence introduced at trial further established that R&S, St. Theresa and New Day were community mental health centers that purported to provide intensive mental health services to Medicare beneficiaries.  On behalf of the recruited beneficiaries, the centers billed Medicare for costly partial hospitalization program (PHP) services that were not medically necessary or not provided to patients, according to trial evidence.  Trial evidence demonstrated that patient records, including group therapy session notes, were falsified to support claims for reimbursement from Medicare.  Between January 2008 and December 2010, the centers submitted approximately $70 million in false and fraudulent claims to Medicare.  Medicare paid approximately $28 million on those claims, the evidence showed. 

In December 2015, co-defendants Santiago Borges, Erik Alonso and Cristina Alonso were sentenced to prison terms ranging from 28 months to 120 months on related charges. 

The FBI investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida.  Trial Attorneys A. Brendan Stewart and Timothy Loper of the Criminal Division’s Fraud Section prosecuted the case. 

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion.  In addition, the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services, working in conjunction with the HHS Office of Inspector General, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.  

16-364
Topic: 
Healthcare Fraud
StopFraud
Updated August 10, 2016