Miami-Dade County

Miami man gets 15 years in nation’s biggest Medicare therapy scam

A Miami physician's assistant who was described by his lawyer as a “bit player” in a nearly $200 million mental health scheme to swindle Medicare was sentenced to 15 years in prison on Tuesday.

But it could have been worse for Roger Bergman, 65, of Miami, who was facing up to 25 years under federal sentencing guidelines for his supporting role in the biggest mental-health clinic scam ever orchestrated against the taxpayer-funded Medicare program.

Bergman, convicted in July of a fraud conspiracy, conducted bogus evaluations of hundreds of patients and falsified their records to dupe Medicare into believing they needed the costly therapy services, according to trial evidence.

Bergman is among the last of about 40 defendants who have been convicted in the high-profile criminal case of American Therapeutic Corp. The Miami-based company, with a network of seven clinics, was shuttered in 2010 after collecting about $87 million in Medicare payments for bogus therapy sessions purportedly provided to drug addicts, alcoholics and people suffering from dementia.

Bergman, who was trained as a doctor in Spain, worked in two of American Therapeutic’s clinics in Miami and Homestead during the past decade.

“They trafficked human beings ... and used those people to try to steal $200 million from Medicare,” Justice Department prosecutor Nicholas Surmacz said at Bergman’s sentencing hearing. “He literally put tens of millions of dollars into the owners’ pockets.”

On Tuesday, Justice Department prosecutors urged U.S. District Judge Jose Martinez to give Bergman 16 1/2 years, while his defense attorney asked for six years after family members sought mercy for the longtime healthcare professional.

Outside the courtroom, Bergman’s wife, Marcy, said she could not fathom why her husband’s former boss, psychiatrist Alberto Ayala, received a 10-year sentence while Bergman got a stiffer prison term. Like Bergman, Ayala was convicted at trial.

“Ayala got 10 years and he was his supervisor,” said Marcy, surrounded by her son and other relatives. “This is crazy. I’m not stopping here.”

At trial in July, Surmacz said the physician's assistant processed the patients for Ayala, who was sometimes out of the country despite records purportedly showing he was at the Miami and Homestead clinics seeing patients.

Agents with the FBI and Health and Human Services raided American Therapeutic's chain in the fall of 2010, leading to the guilty plea of its co-owner and chief executive, Lawrence Duran, who was sent to prison for 50 years — the longest sentence ever for a Medicare fraud offender. His girlfriend, Marianella Valera, the co-owner and therapist, was sentenced to 35 years. They lived in a Miami bayfront condo and tooled around in a Maserati.

Bergman’s defense lawyer, Terence Lenamon, argued in court papers that his client is a modest, married man of poor health who was a salaried American Therapeutic employee and did not enjoy the Medicare riches of Duran, Valera and their inner circle of co-conspirators. Bergman was paid $90,000 a year before leaving American Therapeutic in August 2008, two years before it was shut down.

“Roger was a mere ‘bit player’ in comparison to the big fish Duran, Valera [and the others],” Lenamon wrote. “Roger was an expendable quantity, whereas the others were nececessary participants for the fraudulent [Medicare] scheme.”

Lenamon urged the judge to depart from the sentencing guidelines for Bergman’s offense, saying they defied common sense. The guidelines put “him in the potential company of murderers, kidnappers, airplane hijackers and people whose conduct is waging war against the United States,” Lenamon wrote about the sentencing guidelines.

At trial, Justice Department lawyers said that Bergman helped carry out the mental health chain's fraudulent activity by accepting patients who were in such bad condition that they could not have benefited from any group psychotherapy sessions at American Therapeutic.

To make their case, Justice Department lawyers deployed fraudulent billing records, patient ledgers, bank accounts, corporate emails and key cooperating witnesses.

Among them: American Therapeutic's former co-owner, Valera, who is expected to get a sentence reduction, and the company's one-time marketing director, Margarita Acevedo, who was in charge of doling out millions of dollars to patient recruiters and Medicare beneficiaries. Acevedo was sentenced to 4 1/2 years because of her early cooperation in the case.

  Comments