Miami-Area Man Pleads Guilty for Role in $63 Million Health Care Fraud Scheme

https://www.justice.gov/opa/pr/miami-area-man-pleads-guilty-role-63-million-health-care-fraud-scheme

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Tuesday, November 21, 2017

Miami-Area Man Pleads Guilty for Role in $63 Million Health Care Fraud Scheme

A Miami-area, Florida man pleaded guilty today for his role in a $63 million health care fraud scheme involving a now-defunct community mental health center located in Miami that purported to provide partial hospitalization program (PHP) services to individuals suffering from mental illness.
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Samuel Konell, 70, of Boca Raton, Florida, pleaded guilty to one count of conspiracy to defraud the United States and to receive health care kickbacks before U.S. District Judge Jose E. Martinez of the Southern District of Florida. Sentencing has been scheduled for Jan. 30 before Judge Martinez. Konell was charged in an indictment unsealed on June 9.

As part of his guilty plea, Konell admitted that from approximately January 2006 through June 2012, he received kickbacks and/or bribes in return for referring Medicare beneficiaries from the Miami-Dade state court system to Greater Miami Behavioral Healthcare Center Inc. (Greater Miami) to serve as patients. Specifically, Konell admitted that he coordinated with criminal defendants in the state court system to obtain court orders for mental health treatment in lieu of incarceration so that Konell could refer those individuals to Greater Miami to serve as patients in return for kickbacks and/or bribes. Konell further admitted that he did so knowing that certain of those individuals were not mentally ill or otherwise did not meet the criteria for PHP treatment.
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In furtherance of the kickback conspiracy, Konell made representations to judges and others in the Miami-Dade state court system that the individuals he referred to Greater Miami received medically necessary PHP services from Greater Miami when in reality such services were not always needed, he admitted.

According to plea documents, Konell’s co-conspirators caused the submission of over $63 million in false and fraudulent claims to Medicare. These claims were based on kickbacks and/or bribes paid to Konell and others and were for services that were medically unnecessary, were not eligible for Medicare reimbursement or were never provided by Greater Miami. Konell admitted that his participation in the Greater Miami scheme resulted in the submission of claims to Medicare totaling between at least approximately $9.5 and $25 million.
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