Miami Woman to Serve 37 Months for Her Part in Medicare Fraud Scheme

Billy Denica, a Miami-area resident and owner of an assisted living facility, has pleaded guilty to conspiracy to commit healthcare fraud and has been sentenced to 37 months in prison for her part in a Medicare fraud scheme. As part of the scheme, people like Ms. Denica were paid kickbacks for referring patients to American Therapeutic Corp. (ATC), a fraudulent mental health facility. In addition to her prison time, Ms. Denica will serve two years of supervised release, and she must pay restitution of $538,875.

Ms. Denica agreed to send residents of her Robyll Care Assisted Living Facility to ATC, and in exchange ATC agreed to pay Ms. Denica illegal kickbacks. ATC claimed to provide partial hospitalization programs (PHP), a type of intensive treatment for serious mental illness. , According to the Justice Department, Ms. Denica’s participation in the scheme caused over $1.1 million in false claims to be submitted to the Medicare program.

Ms. Denica was well aware of the consequences of her actions. She has admitted that she was aware ATC submitted false claims to Medicare for PHP treatment for the patients she fraudulently referred to ATC. Ms. Denica also knew that some Robyll residents would receive gifts such as cigarettes, candy, or money to encourage them to agree to being admitted to the hospital and later to ATC for PHP treatment. She acknowledged that she referred Medicare recipients to ATC so that she would receive kickbacks.

More than 20 individuals, as well as ATC and its management company, Medlink Professional Management Group Inc., have pleaded guilty or been convicted for their role in the scheme.

Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in a variety of fraud cases. Contact us or call our attorneys at 800.226.9880 to learn more about our practice and how we can assist.

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