President of Miami-Based Transportation Company Sentenced to 60 Months in Prison for Role in $70 Million Health Care Fraud Scheme
One thing that the government’s ongoing crackdown on Medicare fraud has demonstrated is that where there is fraud there is often conspiracy to commit fraud. This was demonstrated earlier this month when The U.S. Justice Department announced that – in conjunction with the Miami Division of the FBI – the president of a transportation company based in the city had been sentenced to 60 months in prison for his involvement in a health care fraud scheme. The man, Damian Mayol of Miami, was sentenced by U.S. District Judge Ursula in a scheme involving three mental health centers. Mayol was alleged to have submitted fraudulent claims that cost Medicare $70 million. Judge Ursula, of the Southern District of Florida, ordered that Mayol pay more than twenty-six million dollars in restitution and that he forfeit the same amount. In January of this year, Mayol was also convicted of conspiracy to pay health care kickbacks after a five-day trial. The case is part of the current administration’s aggressive prosecution of Medicare Fraud Cases.
Moreover, the government established that the three health care centers purported to provide mental health services to Medicare beneficiaries. Furthermore, the government presented evidence that these health care providers – R&S, St. Theresa and New Day – billed Medicare for partial hospitalization program services (PHP) that were either not provided or that were medically unnecessary. The evidence at trial also showed that patient records had been falsified in order to support Medicare reimbursement claims. These acts are alleged to have occurred between January 2008 and December 2010 costing Medicare $28 million. (Approximately $70 million in false claims had been submitted.) In December 2015, several 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 coordinated with The Medicare Strike Force, the US Attorney’s Office and the Southern District of Florida to investigate and prosecute this case. Several trial attorneys of the Criminal Division’s Fraud Section aided in the prosecution of this case. Since it began back in 2007, the Medicare Fraud Strike Force has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion. Often cases of this kind involve the Federal Whistleblower Act which grants whistleblowers a certain portion of any award collected by the government. If you have information concerning Medicare fraud then you should consult an attorney who knows and is familiar with whistleblower law and who knows how to handle qui tam law suits.