In the capital of medicare fraud, Miami therapist Paul Thomas Layman and his cohorts pulled off a doozy of a heist, stealing $63 million from the federal government through bogus mental health services. Now Layman will spend the next nine years in federal prison following his sentencing hearing yesterday. The case against Layman shows how south Florida is ground zero for the nation's booming medicare fraud racket.
The 66-year-old former health clinic director, who pleaded guilty in March, worked at now defunct health provider Health Care Solutions Network Inc, or HCSN. He was a substance abuse counselor, therapist and clinical director of HCSN's Partial Hospitalization Program, which provides intensive treatment for severe mental illness.
Layman worked at three community mental health centers owned by HCSN of Florida. According to court documents, Layman was aware that HCSN-FL paid illegal kickbacks to owners and operators of Miami-Dade County assisted living facilities in exchange for patient referral information that was used to submit false and fraudulent claims to Medicare and Medicaid. Layman also knew that many of the ALF referral patients were ineligible for PHP services because many patients suffered from mental retardation, dementia and Alzheimer's disease.
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Layman was aware that HCSN-FL personnel were fabricating patient medical records, federal prosecutors alleged. Many of these medical records were created weeks or months after the patients were admitted to HCSN-FL for purported PHP treatment and were utilized to support false and fraudulent billing to government sponsored health care benefit programs, including Medicare and Florida Medicaid. During his employment at HCSN-FL, Layman signed fabricated PHP therapy notes and other medical records used to support false claims to government sponsored health care programs.
According to court documents, from 2004 through 2011, HCSN billed Medicare and the Florida Medicaid program approximately $63 million for purported mental health services.
Follow Francisco Alvarado on Twitter: @thefrankness.