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Physical Therapy Clinic Owners Charged with Medicare Fraud

Federal prosecutors in Tampa unsealed a thirty-count indictment this week charging Luis Duluc, formerly of Weston, Florida, and Margarita Grishkoff of North Carolina with conspiracy to commit health care fraud, and additional substantive counts of health care fraud, making false statements related to a health care matter, and aggravated identity theft.

According to the indictment, Duluc and Grishkoff used three physical therapy clinics in the Middle District of Florida to fraudulently bill Medicare for services not rendered to any Medicare beneficiaries between June 2005 and April 2008. The physical therapy clinics were West Coast Rehabilitation, Inc. (Fort Myers); Rehab Dynamics, Inc. (Venice); and Polk Rehabilitation, Inc. (Lake Wales).

The government alleges Duluc and Grishkoff paid patient recruiters to acquire Medicare beneficiary information for purposes of falsely billing Medicare. In addition, upon acquisition of their physical therapy clinics, they also allegedly acquired the historical patient records left at the clinic sites, including the names and identification numbers of Medicare beneficiaries. As a part of their scheme to defraud Medicare, Duluc and Grishkoff used this Medicare beneficiary information to fraudulently bill Medicare.

Prosecutors also claim Duluc and Grishkoff allegedly allowed others, who owned and operated similarly illegitimate physical therapy clinics in the Southern and Middle Districts of Florida, to use Duluc's and Grishkoff's clinics to submit fraudulent claims for reimbursement to Medicare. Based on their arrangement, Duluc and Grishkoff purportedly accepted bogus patient records and billing forms from the co-conspirator clinics and billed Medicare for services as if they had been provided by Duluc's and Grishkoff's clinics.

The Medicare fraud proceeds were generally split 80/20 by the parties, with 80% going to the co-conspirator clinics and 20% being kept by Duluc's and Grishkoff's clinics.

The indictment alleges that, as a result of Duluc's and Grishkoff's health care fraud scheme, Medicare paid out approximately $8,152,262.14 for services not rendered. According to court documents, the federal government is seeking a money judgment in the amount of $8,152,262.14, which constitutes the proceeds of Duluc's and Grishkoff's alleged health care fraud conspiracy.

If convicted, Duluc and Grishkoff each face a maximum penalty of ten years in federal prison for the conspiracy charge; ten years for each health care fraud charge (19 counts); five years for each false statement charge (6 counts), along with a mandatory minimum term of two years in federal prison for the aggravated identity theft charges (4 counts).

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