Former healthcare clinic consultant, biller sentenced to 11 years in prison for role in $63M fraud
Nery Cowan, 53, of Miami, directed and authorized kickback payments and bribes to patient brokers, got percentage of reimbursements, authorities say.
A former healthcare clinic consultant and Medicare biller has been sentenced to a little more than 11 years in prison, and ordered to pay a $100,000 fine, for her role in a $63 million healthcare fraud scheme involving a now-defunct Miami health provider, the Department of Justice announced earlier this week.
Nery Cowan, 53, of Miami, was sentenced after pleading guilty to one count of conspiracy to commit money laundering in January.
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According to the DOJ, Cowan admitted she acted as a consultant and Medicare biller for Greater Miami Behavioral Healthcare Center, a partial hospitalization program that claimed to provide intensive treatment for the severely mentally ill. Cowan directed and authorized payment for kickbacks and bribes to patient brokers and others in exchange for Medicare beneficiary referrals. Cowan also admitted that Center personnel regularly falsified medical records affiliated with the recruited beneficiaries in support of fraudulent claims to Medicare, the DOJ said.
Court documents show that from 2006 through 2014, Greater Miami Behavioral Healthcare Center billed Medicare for $63 million.
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Cowan received a percentage of the Medicare reimbursement as compensation, the DOJ said, and also admitted that along with two co-defendants, she attempted to hide the kickback payments through shell companies owned by "patient brokers" who solicited Medicare beneficiaries from assisted living facilities, halfway houses and drug courts. According to her plea, Cowan and her co-defendants disguised the kickbacks as "outreach" or "marketing" payments through HNB-Stell Care Inc., a sham staffing company, said the DOJ.
The FBI and Health and Human Services Office of the Inspector General investigated the case.
