Miami Health Care Clinic Director Sentenced to 100 Months in Jail for Medicare Fraud

47-year-old Rafael Alalu, the clinical director of Biscayne Milieu, a Miami-based mental-health clinic, has been sentenced to 100 months in prison for his role in a $50 million (€39 million) Medicare fraud scheme. 

A number of owners, doctors, managers, therapists, patient brokers and other employees of Biscayne Milieu have also been charged for their involvement in the scheme, the US Department of Justice informs.

According to court documents, the defendants and their co-conspirators defrauded Medicare through the clinic by claiming to operate a partial hospitalization program (PHP) – a form of intensive treatment for severe mental illness. 

In reality, they paid recruiters to bring them ineligible Medicare beneficiaries. Services were never provided to these patients, but documents were forged to appear as if treatment had been provided to them.

The former director was convicted in August of conspiracy to commit health care fraud and health care fraud.  Besides the jail sentence, Alalu and his co-defendants have been ordered to pay more than $5.6 (€4.36 million) million in restitution.