Lawrence Duran: Medicare Fraud, Sentencing, and Commutation

Lawrence Duran is a former South Florida healthcare executive who ran one of the largest Medicare fraud schemes in U.S. history, billing the program more than $205 million for mental health services that were medically unnecessary or never provided. He pleaded guilty in April 2011 to 38 felony counts and was sentenced that September to 50 years in federal prison, at the time the longest sentence ever imposed in a Medicare Fraud Strike Force case.¹ In May 2025, President Donald Trump commuted his sentence to time served and wiped out his $87 million restitution obligation.²

How the Scheme Worked

Duran and his co-owner Marianella Valera ran American Therapeutic Corporation from roughly 2002 until their arrest in October 2010. ATC operated purported partial hospitalization programs — an intensive outpatient treatment meant for patients with severe psychiatric conditions — at seven locations across South Florida and Orlando. The programs were not legitimate.³

Most patients were ineligible. Paid brokers pulled them from assisted living facilities and halfway houses. Some were in neuro-vegetative states or suffered from late-stage diseases causing permanent cognitive memory loss, leaving them incapable of responding to counseling.⁴ According to the Miami Herald, ATC submitted roughly 866,000 false claims for group mental health sessions that were fabricated or medically pointless.⁵

To dress the billing up as legitimate, ATC’s operators falsified patient files, therapist notes, diagnoses, and medication records. Two doctors on the payroll, Mark Willner and Alberto Ayala, “robo-signed” patient files without reading them or seeing the patients. More than $100 million in claims were billed under their names for patients they never treated. Ayala signed off on files for services supposedly rendered while he was out of the country on vacation.⁴

Kickbacks and Laundering

ATC spent tens of millions of dollars on bribes and kickbacks to keep patients coming in. Owners of assisted living facilities and halfway houses, along with freelance patient brokers, received payments for delivering Medicare beneficiaries who did not qualify. In some cases the patients themselves got a cut.⁶

To move the money, Duran and Valera set up a subsidiary called Medlink Professional Management Group Inc. and used what prosecutors described as “phony corporations” to convert Medicare payments into cash. Checks were cashed at various locations in amounts structured to stay below federal reporting thresholds. The Miami Herald reported that Medlink laundered approximately $83 million in Medicare payments, distributing funds to Duran, Valera, employees, and others in the scheme.⁵ A separate entity, American Sleep Institute, was used to bill Medicare for unnecessary sleep studies.¹

The Guilty Plea and 50-Year Sentence

Duran and Valera were arrested on October 21, 2010. A superseding indictment was unsealed on February 15, 2011, and both pleaded guilty on April 14, 2011. Duran admitted to all 38 felony counts: conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to pay and receive illegal healthcare kickbacks, conspiracy to commit money laundering, money laundering, and structuring financial transactions to avoid reporting requirements.⁷

On September 16, 2011, U.S. District Judge James Lawrence King sentenced Duran to 50 years in federal prison, ordered him to pay more than $87 million in restitution jointly with his co-defendants, and imposed three years of supervised release. The Department of Justice called it the longest prison sentence ever imposed in a Medicare Fraud Strike Force case.¹ Valera was sentenced three days later to 35 years on 21 felony counts.⁸

The 2025 Commutation

On May 28, 2025, during his second term, Trump commuted Duran’s 50-year sentence to time served. The clemency warrant went beyond a standard commutation. It also eliminated Duran’s restitution obligation of $87,533,863.46 and specified that he would face no further fines related to the case.²⁹

Congresswoman Ayanna Pressley raised the case at a June 2026 hearing of the House Oversight Committee’s Task Force on Defending Constitutional Rights. She said Trump had “wiped away” the restitution a federal judge ordered Duran to pay, leaving the fraud’s victims with no path to recovery. Her December 2025 report, “Trump’s Clemency Gap,” found that Trump’s clemency grants had collectively cost the federal government approximately $1.4 billion in lost restitution and fines, with fraud cases accounting for roughly $1 billion of that figure.¹⁰⁹

Part of a Broader Pattern

Duran’s commutation was not isolated. Across both Trump terms, more than 70 individuals convicted of fraud received clemency, according to the New York Times, and at least seven were doctors or healthcare executives convicted in major Medicare fraud schemes.¹¹ They included Philip Esformes, a Florida nursing home operator convicted in a $1.3 billion Medicare and Medicaid scheme, whose 20-year sentence Trump commuted in December 2020 after roughly four and a half years served, and Salomon Melgen, a Florida eye doctor convicted of defrauding Medicare of $42 million through unnecessary procedures on elderly patients, whose 17-year sentence Trump commuted in January 2021.¹²

Former DOJ pardon attorney Elizabeth Oyer said the pattern showed preferential treatment: “The war on fraud seems like a war on specific fraud committed by a specific kind of people… He sees a wealthy and successful businessman and he sees something of himself in him.”¹³¹²¹⁴

Where the Co-Owners Stand

Duran was the second ATC owner to receive clemency. Judith Negron, a third co-owner who served as vice president of Medlink and was sentenced to 35 years after a jury convicted her on 24 felony counts, was the first. Trump commuted her sentence on February 18, 2020, during his first term, after she had served roughly eight years. The White House said the commutation was supported by the CAN-DO Foundation, former interim Attorney General Matt Whitaker, and criminal justice reform advocate Alice Johnson, who had been incarcerated with Negron and, according to Negron’s attorney Barry Wax, personally asked Trump to intervene.¹⁴¹⁵ Craig Holman of Public Citizen said at the time that the president had the authority but that “it’s not how it has ever been done before,” noting Trump appeared to have bypassed the traditional DOJ clemency vetting process.

Marianella Valera, who was sentenced to 35 years, does not appear to have received clemency.¹⁶ Duran, as of 2026, is out of prison with no remaining restitution obligation.

1
U.S. Department of Justice. Owner of Miami-Area Mental Health Company Sentenced to 50 Years in Prison
2
Office of the Governor of California. Trump Criminals
3
U.S. Department of Justice. Owner of Miami-Area Mental Health Company Sentenced to 35 Years in Prison
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U.S. Department of Justice. Doctors, Therapist and Recruiters at Miami-Area Mental Health Care Corporation Convicted
5
Miami Herald. Trump Commutes Sentence of South Florida Medicare Fraud Convict
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U.S. Department of Justice. Owner of Miami-Area Mental Health Company Sentenced to 35 Years in Prison for Orchestrating $205 Million Medicare Fraud Scheme
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U.S. Department of Justice. Owners of Miami-Area Mental Health Company Plead Guilty
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FBI. Owner of Miami-Area Mental Health Company Sentenced to 35 Years in Prison
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U.S. Congress. House Oversight Committee Hearing Document
10
U.S. Congress. Trump’s Clemency Gap Report
11
New York Times. Trump Fraudsters Pardons
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PBS NewsHour. Trump’s Pardons Included Health Care Execs Behind Massive Frauds
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Protect Our Care. The Real Fraud: Trump Pardoned the Nation’s Biggest Health Care Fraudsters
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Bloomberg Law. Clemency for Medicare Fraudster Belies Justice Enforcement Push
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NBC Miami. Trump Commutes Prison Sentence of South Florida Woman Serving Time for Medicare Fraud
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Fierce Healthcare. Florida Woman Doing 35 Years in Prison for Medicare Fraud Has Sentence Commuted by Trump