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Your Daily Posterous Spaces Update September 21st, 2011 American

Therapeutic Corp.: Therapist and CEO nella Valera sent to prison for 35

years in massive Medicare-fraud case -

OrlandoSentinel.com<http://ptmanagerblog.com/american-therapeutic-corp-therapist\

-and-ceo-m>

Posted 1 day ago by [image: _portrait_thumb] Kovacek, PT, DPT,

MSA <http://posterous.com/people/1l1oCkDWEWjv> to

PTManager<http://ptmanagerblog.com>

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Miami therapist gets 35 years in American Therapeutic's Medicare fraud Embedded

media -- click here to see

it.<http://ptmanagerblog.com/american-therapeutic-corp-therapist-and-ceo-m>

By Jay Weaver, The Miami Herald

8:50 p.m. EDT, September 19, 2011

A federal judge Monday issued another lengthy sentence in the nation's

biggest mental-health fraud case, sending a Miami therapist to prison for 35

years.

The sentencing of nella Valera, 40, came only days after the same judge

sent her 49-year-old boyfriend, Lawrence Duran, to prison for 50 years. The

pair ran Miami-based American Therapeutic Corp., which prosecutors say

defrauded the taxpayer-funded

Medicare<http://www.orlandosentinel.com/topic/health/government-health-care/medi\

care-HEPRG00002.topic>program

of more than $200 million.

In both criminal cases, U.S. District Judge Lawrence King gave out the

longest prison sentences ever for a Medicare-fraud offender. Previously, the

longest sentence was a 30-year term imposed in 2008 on a Miami physician

convicted in an HIV-therapy scam.

Embedded media -- click here to see

it.<http://ptmanagerblog.com/american-therapeutic-corp-therapist-and-ceo-m>

his year, Duran and Valera pleaded guilty to a variety of conspiracy, fraud

and money-laundering charges after they failed to reach plea deals

with the Justice

Department<http://www.orlandosentinel.com/topic/crime-law-justice/u.s.-departmen\

t-of-justice-ORGOV0000160.topic>.

Prosecutors had pushed for a 40-year sentencing for Valera — whom they

described as the public " face " of American Therapeutic — but Valera's

lawyer, Arthur Tifford, sought considerably less time.

Justice Department lawyer Saulino argued that Valera abused her

" position of trust " as the licensed owner of American Therapeutic. Duran had

registered the company in her name to disguise his past ownership of a

similar company, which had carried a $2 million debt.

------------------------------

*Video: PETA protests outside SeaWorld hearing*

<http://www.orlandosentinel.com/videogallery/64871875/News/Video-PETA-protests-o\

utside-SeaWorld-hearing#gl-0?track=orl-mark-news-embed-video-peta-protests>

------------------------------

" Valera, a licensed mental

health<http://www.orlandosentinel.com/topic/health/behavioral-conditions/mental-\

health-HEBEC000013.topic>counselor

in the state of Florida, held herself out as the face of American

Therapeutic Corporation, " Saulino wrote in court papers. " She was the

president and CEO — the licensed therapist in charge — whose picture was

prominently [featured] on the ATC website. "

The couple's company, with clinics stretching from Miami to Fort

Lauderdale<http://www.orlandosentinel.com/topic/us/florida/broward-county/fort-l\

auderdale-PLGEO100100403070000.topic>to

Orlando, collected $87 million in Medicare payments after submitting

$205

million in false claims.

The couple paid kickbacks to recruiters to supply patients suffering from

dementia<http://www.orlandosentinel.com/topic/health/diseases-illnesses/alzheime\

rs-disease-HEDAI000007.topic>,

Alzheimer's and addictions, but they could not have benefited from the

company's purported group-therapy sessions.

Saulino, the prosecutor, further noted in court papers: " Valera certified

that she would never knowingly submit claims to the Medicare program with

reckless disregard for their truth or falsity. "

" Valera has admitted she violated that certification for every one of the

bills ATC submitted to Medicare, " Saulino wrote.

The seven-clinic chain filed some 866,000 claims to the federal program for

the elderly and disabled between 2003 and 2010.

Valera and Duran also threw " charting " parties, where they and other

American Therapeutic employees altered patients' records to make it look

like they needed the purported group-therapy sessions when they didn't.

Valera, like Duran, enjoyed the good life until her arrest last October,

thanks to American Therapeutic's profits, according to court records. A

naturalized U.S. citizen from Peru, Valera bought a BMW M3 coupe, an Audi

sports car, a Land Rover Range and a

Harley-son<http://www.orlandosentinel.com/topic/economy-business-finance/ha\

rley-davidson-incorporated-ORCRP007063.topic>motorcycle.

A subsidiary of the clinic chain, MedLink, which was used for money

laundering, issued a check for $212,000 toward Valera's purchase of an Opera

Tower condo overlooking Biscayne Bay.

A total of 34 people, including American Therapeutic employees, doctors,

therapists, nurses and recruiters, have been charged in the ongoing fraud

case, which is being investigated by the

FBI<http://www.orlandosentinel.com/topic/crime-law-justice/crimes/fbi-ORGOV00000\

8.topic>and

Health and Human Services Office of Inspector General.

This year, about a dozen defendants have pleaded guilty — including the

company's marketing director, Margarita Acevedo, who is cooperating with

authorities. On Monday, Judge King sentenced Acevedo to 7 1/2 years in

prison

via

orlandosentinel.com<http://www.orlandosentinel.com/news/local/mh-mental-health-m\

edicare-fraud-20110919,0,2653729.story>

HealthSouth Is Hammered By Medicare Worries -

WSJ.com<http://ptmanagerblog.com/healthsouth-is-hammered-by-medicare-worries-w>

Posted about 22 hours ago by [image: _portrait_thumb] Kovacek,

PT, DPT, MSA <http://posterous.com/people/1l1oCkDWEWjv> to

PTManager<http://ptmanagerblog.com>

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post]<http://posterous.com/likes/create?post_id=71357622>

- SEPTEMBER 20, 2011, 2:28 P.M. ET

HealthSouth Is Hammered By Medicare Worries

<http://online.wsj.com/article/BT-CO-20110920-711317.html?mod=hps_us_my_industri\

es#>

By Russ Britt

LOS ANGELES (Dow )--Shares of HealthSouth Corp. got slammed Tuesday

after the Obama administration targeted rehabilitation hospitals in its

recent proposal to address the nation's deficit problems.

The shares fell 15% to $15.29, a day after the hospital operator (HLS) lost

14% as concerns started to mount that President Barack Obama's $3 trillion

deficit reduction plan included $7 billion in cuts at facilities like those

of Birmingham, Ala.-based HealthSouth.

Obama is proposing going back to what is known as the " 75% rule " for

HealthSouth's facilities in which at least three-fourths of all patients in

a hospital receiving rehabilitative reimbursements must meet the criteria

for one of several diagnoses that fall into the rehab category. Of late,

that threshold had been 60%.

Further, the administration wants to normalize Medicare payment rates for

nursing homes and rehab hospitals.

HealthSouth said Tuesday it will hold a conference call to discuss the

effects of the proposal on Wednesday. Still, some analysts voiced serious

concern.

" Together, they represent a potentially poisonous combination, " said Sheryl

Skolnick, analyst for Capital Group LLC, in a note to clients. Skolnick

lowered her rating on HealthSouth to " fair value " from " buy. "

" It pains us to take this step because we see this as one of the best

managed companies we follow, " she went on to say. " We tried to hold on as

long as we could. But the political risks over the next two months promise

to be intense and should the rehab proposals be enacted, it could have

severe negative impact on [HealthSouth's fiscal 2012 fourth quarter], 2013

and future earnings power. "

Analyst A.J. Rice from Susquehanna Financial Group was skeptical the

proposals would go through as offered by Obama but said if they were enacted

the effects could be troublesome for HealthSouth.

" If the president's two proposals related to [inpatient rehabilitation

facilities] were implemented and the estimated savings targets were correct,

[HealthSouth] might reasonably be expected to face a $115 million-$120

million revenue headwind in 2013, assuming that it absorbed 19% of the

projected payment cuts, " Rice wrote in a note to clients.

But Keegan's Mains noted that HealthSouth outlined that 39 of

its 97 hospitals currently are in compliance with the 75% rule and another

23 are in the 70%-75% range.

" Thus, almost two-thirds of HealthSouth hospitals would have very limited

problems with a revised 60% rule, " the analyst said in a note.

-Russ Britt; ;

AskNewswires@...<http://online.wsj.com/article/BT-CO-20110920-711317.ht\

ml?mod=hps_us_my_industries/mailto:AskNewswiresdowjones>

via

online.wsj.com<http://online.wsj.com/article/BT-CO-20110920-711317.html?mod=hps_\

us_my_industries>

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