Off-label use of powerful antipsychotic drugs has come in for plenty of debate in recent years. The expensive, newer-generation “atypicals” have been used to treat dementia, depression, anxiety, post-traumatic stress disorder, dementia, attention-deficit hyperactivity disorder…the list goes on. And all this while the Justice Department was investigating Big Pharma for off-label promotion of the drugs.
Lawrence Duran was a Miami healthcare executive who regularly lobbied Congress in favor of legislation to boost government subsidies for his industry: community mental health centers. He visited with U.S. Rep. Ileana Ros-Lehtinen in Washington to drum up support. He, his girlfriend and other members of his lobbying organization threw a fundraiser for another Miami congressman, Rep. Kendrick Meek, when he ran for the U.S. Senate.
But Justice Department officials paint a far more sinister portrait of Duran and his girlfriend, Marianella Valera. They say the lobbying work was all a front to help them steal more money from the taxpayer-funded Medicare program.
Now Duran and Valera, who each pleaded guilty this year to Medicare fraud charges of running the biggest mental-health racket in the nation, face the prospect of spending the rest of their lives in prison for orchestrating the $205 million scam.
It’s getting personal now. In a shift still evolving, federal enforcers are targeting individual executives in health care fraud cases that used to be aimed at impersonal corporations.
The new tactic is raising the anxiety level — and risks — for corporate honchos at drug companies, medical device manufacturers, nursing home chains and other major health care enterprises that deal with Medicare and Medicaid.
Johnson & Johnson could be on the hook for about $1 billion to settle the government probe into its Risperdal marketing. Prosecutors are looking for a settlement about that size, the Wall Street Journal reports, citing sources. That would be the third-largest marketing settlement between a Big Pharma company and the U.S. government; only Pfizer and Eli Lilly have made larger deals with the feds.
The first Miami defendant in the nation’s largest mental healthcare fraud case pleaded guilty to paying millions of dollars in kickbacks in exchange for Medicare patients who didn’t need the costly therapy.Her job as marketing director for a Miami-based mental healthcare chain was to bring in the patients and nobody did their job better than Margarita Acevedo. Investigators say she paid millions of dollars in kickbacks to South Florida assisted-living facilities, halfway houses and recruiters to supply thousands of Medicare beneficiaries to American Therapeutic Corp.’s chain of seven clinics — patients who didn’t need the costly treatment.
On Thursday, Acevedo, 41, of Southwest Miami-Dade, pleaded guilty to conspiring to pay kickbacks in exchange for patients and conspiring to bilk between $100 million and $200 million from Medicare, in the largest mental healthcare fraud case in the country. Her change of plea in a Miami federal court makes Acevedo the first defendant among 24 indicted since last fall to admit playing a role in American Therapeutic’s “massive fraud scheme” against the taxpayer-funded healthcare program for seniors and the disabled, according to court records. She faces between 12 and 15 years in prison at her mid-July sentencing, according to sentencing guidelines.
Read more: http://www.miamiherald.com/2011/04/08/2158019/first-miami-defendant-in-nations.html#ixzz1JWM85A6L