Fla. Assisted Living Facility Owner Sent to Prison for $1.1 Million Medicare Fraud Scheme

A Miami-area assisted living facility owner has been sentenced to 37 months in prison for her role in a more than $1.1 million Medicare fraud scheme, says the Department of Justice. Billy Denica was sentenced by U.S. District Judge Joan Lenard in Miami, Fla.; in addition to her prison term, she was sentenced to two years of supervised release and has been ordered to pay $538,875 in restitution. 

The kickback scheme involved funneling patients to a fraudulent mental health provider, American Therapeutic Corporation, in exchange for illegal healthcare kickbacks. Denica, the owner of Robyll Care Assisted Living Facility, admitted she knew ATC falsely billed Medicare for partial hospitalization programs (PHP)—a form of intensive treatment for severe mental illness—based on her fraudulent referrals, court documents say. 

Some of her Robyll residents would be offered gifts such as money, cigarettes, and candy in exchange for agreeing to be admitted to the hospital, so they could then be referred to ATC. Denica herself would also refer her residents to the fraudulent corporation in order to receive cash kickbacks for those who went. 

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The ALF owner’s participation in the fraud resulted in more than $1.1 million in fraudulent billing to the Medicare system, according to the plea agreement. 

ATC, and its management company Medlink Professional Management Group Inc., along with more than 20 other individual defendants charged for their participation in the scheme, have also pleaded guilty, or have been convicted at trial. 

Written by Alyssa Gerace