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December 21, 2012

Ex-director of Miami Gardens mental health clinic imprisoned for 8 years for Medicare fraud

The former director of a Miami Gardens mental health clinic was sentenced to more than eight years in prison for his role in a major Medicare fraud case.

The former director of a mental health clinic in Miami Gardens has been sentenced to more than eight years in prison for his role in a vast conspiracy involving dozens of co-workers who collectively tried to bilk more than $50 million from Medicare.

Rafael Alalu, 47, of Miami, who worked for the Biscayne Milieu clinic, was convicted in August of conspiracy to commit healthcare fraud and two related offenses.

Alalu’s sentencing Thursday before U.S. District Judge Robert Scola was attended by scores of people who spilled out of the courtroom.

The trial evidence showed that Alalu participated in treating ineligible patients, falsifying their files, writing fabricated group therapy notes and instructing other therapists at the clinic to do the same.

More than 25 defendants, including the clinic’s owners, doctors, managers, therapists, other employees and patient brokers, have pleaded guilty or been convicted at trial.

In August, Biscayne Milieu’s owner, Antonio Macli; the company’s operating officer, son Jorge Macli; and another manager, daughter Sandra Huarte, were found guilty of conspiring to commit healthcare fraud by collecting $11 million in taxpayer-funded Medicare payments for therapy services that were not provided or needed from 2007 to 2011.

The family members were also found guilty of conspiring to pay kickbacks to patient recruiters who supplied Medicare beneficiaries living primarily at halfway houses in South Florida.

Some patients, who suffered from substance abuse, were lured from out of state with promises to put a roof over their heads, prosecutors said. They were told if they dropped out of the group therapy sessions, they would lose their housing.

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