Psychiatrists Mark Willner, Alan Gumer and Alberta Ayala among those arrested by feds in "largest criminal case of its kind"

February 15, 2011

Federal agents Tuesday arrested 16 doctors, administrators and others who are accused of participating in a $200 million mental healthcare racket, the largest criminal case of its kind in the country.

Among the 20 defendants charged with conspiring to defraud Medicare are three former medical directors for Miami-based American Therapeutic Corp., which had been indicted along with the clinic chain’s owners last fall.

The defendants – including physicians Mark Willner, Alan Gumer and Alberta Ayala -- were expected to have their first appearances on Tuesday afternoon in Miami federal court.

“As today’s charges reflect, defrauding the Medicare system was not an aberration at ATC, but instead part and parcel of its business operations,” said Assistant Attorney General Lanny A. Breuer of the Justice Department’s criminal division. “By exploiting positions of trust, these defendants masked their fraudulent operation as a legitimate mental health business.”

In October, the federal grand jury indicted American Therapeutic and four senior executives, accusing them of scheming to loot $200 million from the taxpayer-funded Medicare program by billing the program for purported counseling sessions that were either not necessary or provided. Three of the executives were also charged with paying kickbacks to patient recruiters. The case is headed for trial in August.

American Therapeutic’s one-time owner, Lawrence Duran, 48, and former chief executive, Marianella Valera, 39, are being detained at the Miami Federal Detention Center, as the FBI and IRS try to account for much of the $83 million that the notoriously lax Medicare program paid to their seven-clinic company since 2003.

The couple’s detention came after details surfaced on how they and other employees allegedly changed the diagnoses and medications of patients. They would make the changes at “charting parties” to dupe Medicare into believing that the psychotherapy was necessary when, in fact, it wasn’t, Justice Department lawyers say.

The case is being handled by the U.S. Attorney’s Office in Miami, the FBI and the Department of Health and Human Services’ Office of Inspector General.

Source: Jay Weaver, "Feds make more arrests in major Medicare fraud case,"  Miami Herald, February 15, 2011.