WASHINGTON—A federal judge on Tuesday sentenced a Miami physician’s assistant to 15 years in prison for his role involving a Medicare fraud scheme where $200 million in phony billings were submitted by American Therapeutic Corporation , a mental health company that was headquartered in Miami, officials said.
The billings included claims for patients who weren’t eligible for intense treatment for severe mental illness because they were in neuro-vegetative states, officials said.
U.S. District Judge Jose E. Martinez also ordered the defendant Robert Bergman, 65, of Miami, to pay more than $85.3 million as restitution.
After a six-day trial, on July 18, 2014, a federal jury in Florida found Bergman guilty of one count of conspiracy to commit health care fraud and wire fraud, and one count of conspiracy to make false statements relating to health care matters.
Evidence at trial demonstrated that Bergman and his co-conspirators submitted false and fraudulent claims to Medicare through American Therapeutic Corporation, which operated hospitalization programs in seven different locations throughout South Florida and Orlando, authorities said.
A partial hospitalization program is a form of intensive treatment for severe mental illness, officials said.
Evidence showed that Bergman and other medical professionals signed fraudulent medical documentation to justify fraudulent billings to Medicare.
Included in these false submissions to Medicare were claims for patients who were ineligible for PHP treatment because they were in neuro-vegetative states, in the late stages of diseases causing permanent cognitive memory loss, or had substance abuse issues and were living in halfway houses, according to officials.
Many of these patients were forced by assisted living facility owners and halfway house owners to attend American Therapeutic and they did not receive medical treatment, officials said.
American Therapeutic along with an associated management company, and more than 20 individuals, including American Therapeutic’s owners, have all previously pleaded guilty or been convicted at trial.
Bergman has been in federal custody since his conviction, officials said