Three South Floridians plead guilty to bilking Aetna, others for drug-abuse treatment

Three former operators of South Florida substance-abuse treatment centers have admitted they ripped off millions from health insurers by submitting false bills for patients who lived in “sober homes” and didn’t need the services, according to their plea agreements.

Ali Ahmed, 38, Hector Efrain Alvarez, 49, and Mauren Morel, 45, all of Broward and Palm Beach counties, pleaded guilty Wednesday in Miami federal court to conspiring to commit healthcare fraud against a half-dozen major insurers, including Aetna, Blue Cross Blue Shield and Humana.

They operated three treatment centers in Davie — Jacob’s Well, Medi MD and Arnica Health — that submitted a total of $23.5 million in bills for substance-abuse services and received $4.2 million from the private insurers between June 2016 and April 2019, according to prosecutors in the U.S. Attorney’s Office.

Prosecutors Christopher Clark and Lisa Miller said the defendants “falsely and fraudulently represented that various healthcare benefits ... were medically necessary, prescribed by a doctor and provided” by the three treatment facilities, according to a news release.

Ahmed, Alvarez and Morel face up to 20 years in prison at their sentencings on Jan. 21 before U.S. District Judge Federico Moreno in Miami federal court.

A fourth defendant, Sebastian Ahmed, the former CEO of the three Davie treatment centers, has pleaded not guilty and is set for trial on Nov. 25.

In recent years, South Florida has become a magnet for people suffering from addictions to drugs and alcohol. Many addicts, from other parts of Florida and out of state, live in recovery residences, or sober homes, while they receive out-patient substance-abuse services at treatment centers like those in Davie, prosecutors said.

This story was originally published November 15, 2019 at 7:00 AM.