Paul Thomas Layman, Health Care Fraud, Florida 2013

A former health care clinic director and licensed therapist, Paul Thomas Layman, 66, of Miami, was sentenced to 111 months in prison for his role in a $63 million health care fraud scheme involving defunct health provider Health Care Solutions Network Inc. (HCSN).

Layman pleaded guilty on March 7, 2013, to conspiracy to commit health care fraud. During the course of the conspiracy, Layman was employed as a substance abuse counselor, therapist, and clinical director of HCSN’s Partial Hospitalization Program (PHP), a form of intensive treatment for severe mental illness.

HCSN of Florida (HCSN-FL) operated community mental health centers at three locations. Layman worked full-time at all HCSN-FL locations in various capacities. According to court documents, Layman was aware that HCSN-FL paid illegal kickbacks to owners and operators of Miami-Dade County Assisted Living Facilities (ALF) in exchange for patient referral information to be used to submit false and fraudulent claims to Medicare and Medicaid.

Layman also knew that many of the ALF referral patients were ineligible for PHP services because many patients suffered from mental retardation, dementia, and Alzheimer’s disease. Court documents reveal that Layman was aware that HCSN-FL personnel were fabricating patient medical records. Many of these medical records were created weeks or months after the patients were admitted to HCSN-FL for purported PHP treatment and were utilized to support false and fraudulent billing to government-sponsored health care benefit programs, including Medicare and Florida Medicaid.

Layman signed fabricated PHP therapy notes and other medical records used to support false claims to government-sponsored health care programs. HCSN of North Carolina (HCSN-NC) operated one location in Hendersonville, N.C. At HCSN-NC, Layman served as the clinical director and assisted HCSN owner Armando Gonzalez in obtaining necessary licensing, credentials, and Medicare authorizations for HCSN-NC.

According to court documents, from 2008 through 2009, Layman purportedly supervised the therapists within the HCSN-NC PHP, including Alexandra Haynes, who was an unlicensed therapist purportedly performing PHP therapy to HCSN-NC patients. Gonzalez and Haynes were sentenced to 168 months and 70 months, respectively, in prison.

This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Related Federal Cases