The indictment alleges that Ernesto Angel Montaner and Ernesto Montaner, together with other conspirators, operated and controlled multiple physical and occupational therapy clinics, including Infinity Therapy, Mega Therapy Center and Miami Dade Medical Group. The Montaners, with Mr. Varona, also controlled a fourth PT/OT clinic, known as Florida Rehabilitation Clinic, according to the release.
According to the indictment, Ernesto Angel Montaner and Ernesto Montaner allegedly made periodic cash kickback payments to patient recruiters and to an undercover law enforcement officer posing as a patient recruiter, in return for the referral of Medicare beneficiaries for PT/OT services. The indictment further alleges that Ernesto Angel Montaner, Ernesto Montaner and Mr. Varona paid periodic cash kickbacks to the owners of assisted living facilities, home health agencies and other medical facilities that referred Medicare beneficiaries to Infinity Therapy, Mega Therapy or Florida Rehabilitation Clinic for PT/OT services, according to the release.
The conspirators allegedly paid the kickbacks without regard to the Medicare beneficiaries’ actual medical condition and without regard to whether PT/OT services were medically necessary, according to the release. The indictment further alleges that the Montaners concealed kickbacks by issuing checks from Infinity Therapy payable to JAV Consulting, a shell corporation controlled by Mr. Varona or to other shell corporations controlled by Mr. Varona’s personal associates, who then allegedly used the funds to make illegal cash kickback payments to patient recruiters and to the owners of various medical facilities.
The indictment also alleges that the conspirators submitted fraudulent claims to Medicare on behalf of Infinity Therapy, Mega Therapy, Miami Dade Medical and Florida Rehabilitation Clinic for PT/OT services rendered by unlicensed and unqualified physical therapists, occupational therapists and therapy assistants, according to the release. Some of the beneficiaries involved were actually cooperating government witnesses. Information also alleges that after Feb. 2008, when a complicit supervising physician working for Ernesto Angel Montaner died of natural causes, the conspirators continued to submit claims to Medicare for PT/OT services that were primarily overseen by a “physician” who was not actually licensed in the United States. The defendants also allegedly created “billing templates” that were designed to ensure that Medicare was typically billed for at least 17 PT/OT sessions, using an optimized set of predetermined billing codes, regardless of how many times the Medicare beneficiary actually visited the clinic, and regardless of the Medicare beneficiaries’ actual health. The defendants allegedly used modifier codes to bypass Medicare’s normal annual financial limits for PT/OT services. Based on these schemes and others described in the charging documents, the conspirators submitted more than $2.5 million of false claims to Medicare, according to the release.
Read the FBI’s release on Ernesto Angel Montaner.
