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Florida cracks down on fraud tied to therapy clinics

Tampa man sentenced 11 years in false claims case; Orlando couple charged with Medicare fraud

A Florida man who owned and operated multiple physical therapy rehabilitation facilities was sentenced to 11 years in federal prison for fraudulently billing Medicare for $28.3 million in physical and occupational therapy services.  

In February, Luis Duluc, 54, of Tampa, pleaded guilty to conspiracy to commit healthcare fraud as well as making a false statement relating to healthcare matters, according to an FBI announcement. Duluc admitted to purchasing comprehensive rehabilitation and outpatient physical therapy providers throughout Florida, and then using the Medicare provider numbers associated with those facilities to submit false claims to Medicare for services that were not actually rendered.

Duluc also admitted to paying kickbacks to obtain personal information of Medicare beneficiaries and using forged patient records to conceal the fraudulent claims. The FBI added that, once Duluc and his co-conspirators were done with the clinics, they sold them to recent immigrants in an effort to separate them from the fraudulent clinics.

Elsewhere in Florida, the Orlando Sentinel reported that husband-and-wife owners of a rehab center in Orlando were charged with five counts of healthcare fraud and one count of conspiracy to commit money laundering. The couple fraudulently billed $3 million in chemotherapy prescriptions that were not medically necessary and not provided.

A string of recent cases exemplify the federal crackdown on fraud involving therapeutic services, FierceHealthPayer: AntiFraud previously reported.

What's more, a November report from the Office of Inspector General indicated that outpatient therapy providers are among the Medicare services that have been consistent targets of fraud and questionable billing patterns, along with home health agencies, mental health centers, clinical laboratories, and ambulance transportation suppliers.

For more:
- read the FBI announcement
- here's the Orlando Sentinel article
- see the OIG report

Related Articles:
Feds crack down on therapeutic services fraud
The frequent link between fraud and altered records
Fraud by unlicensed providers a growing concern