Feds: Firm Used Dementia Patients in $200M Scam

Health center charged with Medicare fraud
By Newser Editors and Wire Services
Posted Oct 21, 2010 12:25 PM CDT
Feds: Firm Used Dementia Patients in $200B Scam
In this photograph taken by AP Images, Health and Human Services Secretary Kathleen Sebelius is shown at the first National Summit on Health Care Fraud, January 28, 2010 in Bethesda, Maryland.   (Jose Luis Magana/AP Images for Centers for Medicare & Medicaid Services)

Federal authorities charged the nation's largest community mental health center today, alleging the Miami-based company billed Medicare $200 million in a scam that preyed on patients with severe dementia and altered their clinical files so the company could charge for more services. Prosecutors alleged that American Therapeutic Corp. paid the owners of assisted living facilities and halfway houses to force patients to attend programs at their seven mental health centers in south and central Florida

Some patients also cashed in on the scheme by providing their Medicare numbers, while others were "not coherent enough" to demand kickbacks, according to the investigation by the departments of Justice and Health and Human Services. The grand jury indictment alleges that ATC routinely billed Medicare for therapy and other services patients weren't actually eligible for. Doctors were allegedly told to falsify medical charts to make it look like patients had a mental illness and needed medication and therapy to be stabilized. (More Medicare stories.)

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