Dr. Mark Willner and
Dr. Alberto Ayala Sentenced to Prison for Participating in $205M
Medicare Fraud Scheme
October 01, 2012
Miami-area residents Dr. Mark Willner and Dr. Alberto Ayala, former
medical directors at the mental health care company American Therapeutic
Corporation (ATC), were each sentenced today to 10 years in prison for
participating in a $205 million Medicare fraud scheme, announced
Assistant Attorney General Lanny A. Breuer of the Justice Department’s
Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern
District of Florida; Special Agent in Charge Michael B. Steinbach of the
FBI’s Miami Field Office; and Special Agent in Charge Christopher Dennis
of the HHS-Office of Inspector General (HHS-OIG), Office of
Investigations Miami Office.
Willner, 56, and Ayala, 68, were sentenced by U.S. District Judge
Patricia A. Seitz in the Southern District of Florida. Judge Seitz
ordered Willner to pay more than $57 million in restitution and Ayala to
pay more than $87 million in restitution, both jointly and severally
with their co-defendants. Willner and Ayala were also both sentenced to
three years of supervised release following their prison terms.
On June 1, 2012, after a seven-week trial, a federal jury in the
Southern District of Florida found Willner and Ayala each guilty of one
count of conspiracy to commit health care fraud.
Evidence at trial demonstrated that the defendants and their
co-conspirators caused the submission of false and fraudulent claims to
Medicare through ATC, a Florida corporation headquartered in Miami that
operated purported partial hospitalization programs (PHPs) in seven
different locations throughout South Florida and Orlando. A PHP is a
form of intensive treatment for severe mental illness. The defendants
and their co-conspirators also used a related company, American Sleep
Institute (ASI), to submit fraudulent Medicare claims.
Evidence at trial revealed that ATC secured patients by paying kickbacks
to assisted living facility owners and halfway house owners who would
then steer patients to ATC. These patients attended ATC, where they were
ineligible for the treatment ATC billed to Medicare and where they did
not receive the treatment that was billed to Medicare. After Medicare
paid the claims, some of the co-conspirators then laundered the Medicare
money in order to create cash to pay the patient kickbacks.
The defendants were charged in an indictment returned on February 8,
2011. ATC, the management company associated with ATC, and 20
individuals, including the ATC owners, have all previously pleaded
guilty or have been convicted at trial.
Evidence at trial revealed that doctors at ATC, including Willner and
Ayala, signed patient files without reading them or seeing the patients.
Evidence further revealed that ATC then billed Medicare for more than
$100 million in PHP treatment for these patients under the names of
Willner and Ayala. Included in these false and fraudulent submissions to
Medicare were claims for patients in neuro-vegetative states, along with
patients who were in the late stages of diseases causing permanent
cognitive memory loss and patients who had substance abuse issues and
were living in halfway houses. These patients were ineligible for PHP
treatment, and because they were forced by their assisted living
facility owners and halfway house owners to attend ATC, they were not
receiving treatment for the diseases they actually had.
Willner and Ayala have been in federal custody since their convictions.
executives Lawrence Duran, Marianella Valera, Judith Negron, and
Margarita Acevedo were sentenced to 50 years, 35 years, 35 years, and 91
months in prison, respectively, for their roles in the fraud scheme. The
50- and 35-year sentences represent the longest sentences for health
care fraud ordered to date. Acevedo, who pleaded guilty early on and has
been cooperating with the government since November 2010, testified at
the doctors’ trial.
ATC and Medlink pleaded guilty in May 2011 to conspiracy to commit
health care fraud. ATC also pleaded guilty to conspiracy to defraud the
United States and to pay and receive illegal health care kickbacks. On
September 16, 2011, the two corporations were sentenced to five years of
probation per count and ordered to pay restitution of $87 million. Both
corporations have been defunct since their owners were arrested in
The case was prosecuted by Trial Attorneys Jennifer L. Saulino, Robert
A. Zink, and James V. Hayes of the Criminal Division’s Fraud Section.
The case was investigated by the FBI and HHS-OIG and was brought as part
of the Medicare Fraud Strike Force, supervised by the Criminal
Division’s Fraud Section and the U.S. Attorney’s Office for the Southern
District of Florida.
Since its inception in March 2007, the Medicare Fraud Strike Force, now
operating in nine cities across the country, has charged more than 1,330
defendants who have collectively billed the Medicare program for more
than $4 billion. In addition, HHS’s Centers for Medicare and Medicaid
Services, working in conjunction with HHS-OIG, is taking steps to
increase accountability and decrease the presence of fraudulent