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Forum Post: 14 Chicago-area residents charged in Medicare fraud cases. A Chicago doctor and pharmacist- as well as several others involved locally in the industry- were charged in connection with federal health care fraud cases.

Posted 2 years ago on Jan. 17, 2012, 7:07 p.m. EST by ModestCapitalist (2342)
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14 Chicago-area residents charged in Medicare fraud cases.

February 17, 2011 (CHICAGO) (WLS) -- A Chicago doctor and pharmacist- as well as several others involved locally in the industry- were charged in connection with federal health care fraud cases.

Arrest warrants were executed for 10 of the 14 Chicago men and women indicted in eight separate, unrelated health care fraud cases as part of a national takedown by Medicare Fraud Strike Force operations. As many as 111 defendants nationwide were charged for alleged participation in Medicare fraud schemes.

"With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country. We have safeguarded precious taxpayer dollars. And we have helped to protect our nation's most essential health care programs, Medicare and Medicaid," said Attorney General Holder. "As today's arrest prove, we are waging an aggressive fight against health care fraud."

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[-] 1 points by ModestCapitalist (2342) 2 years ago

111 charged in Medicare scams worth $225 million The Chicago-area defendants were each charged with one or more counts of health care fraud, mail fraud, false statements relating to health care matters, and/or conspiracy.

The accused are:

Virgilio Orillo and Mergigrace Orillo, who co-own and operate Chalice Home Healthcare Serivces, Inc., with offices in Chicago, Freeport, and Morris, Ill. They are accused of falsifying documents to increase Medicare payments and face three counts of health care fraud.

Marilyn Maravilla, 54, of Chicago; Junjee Arroya, 42, of Elmhurst; Ferdinand Echavia, 37, of Chicago; Kennedy Lomillo, 43, of Mundelien; and Baltazar Alberto, 47, of Morton Grove; are associated with Goodwill Home Healthcare, Inc. They are accused of receiving kickbacks for the referral of Medicare patients for home health care services.

Alona Dizon Bugayong, 35, of Lincolnwood; and Han Woo, 35, of Hoffman Estates; are charged with one count of conspiring to pay kickbacks for the referral of patients to home health care agencies run by Han Woo, who operates New Covenant Home Health Agency LLC and Healthquest Homecare LLC.

Dr. Jaswinder Rai Chhibber, 48, of Schaumburg, is the president and owner of the Cottage Grove Community Medical Clinic in Chicago.

Chhibber is charged with one count of health care fraud. Chhibber allegedly submitted medical services reimbursement claims for procedures that were never done to Medicare, Medicaid and Blue Cross Blue Shield of Illinois.

Jay Hammerman, 62, of Chicago, a pharmacist and the owner of Jay's Save Rite Thorndale Pharmacy, is charged with two counts of health care fraud. He is accused of scheming to defraud health care insurance providers, including Medicare and Medicaid by submitting fraudulent reimbursement claims for prescription medications that were never actually dispensed.

Brandy Howard, 35, of Naperville, a licensed chiropractor, is charged with two counts of health care fraud, three counts of mail fraud, and two counts of false statements relating to health care matters. Howard allegedly submitted false claims to Blue Cross Blue Shield for orthotics.

Dr. Andrew Carr, 41, of Lake in the Hills, a licensed chiropractor, is charged with one count of health care fraud for allegedly submitting claims for chiropractic services that were never rendered.

U.S. Occupational Health, a medical services company that performs physical examinations and medical testing for employees of private and governmental entities, is charged with one count of mail fraud. The City of Chicago used USOH to perform physical examinations and medical testing on applicants and employees of various departments, including the Chicago Police Department and the Chicago Fire Department. U.S. Occupational Health allegedly falsely represented results of tests that had not been reviewed by board-certified specialists as required.
[-] 1 points by ModestCapitalist (2342) 2 years ago

Patient Recruiter Pleads Guilty to Healthcare Fraud for Role in Unnecessary Testing Scheme.

Melvin Young of Detroit has pleaded guilty to one count of conspiracy to commit healthcare fraud for his role in an unnecessary medical testing fraud scheme, according to a news release by the U.S. Department of Justice.

According to plea documents, Mr. Young began recruiting and transporting patients in Sept. 2007 to a clinic called Ritecare. Ritecare was owned and operated by co-conspirators and had locations in Detroit and Livonia, Mich. Mr. Young admitted that he and a co-conspirator paid kickbacks, through funds provided by the clinic owners, to Medicare beneficiaries that he recruited and transported to Ritecare. Typically, the owners of Ritecare would provide Mr. Young $100-$150 per patient he recruited, with Mr. Young retaining $50-$75 of that amount for the referral, according to plea documents.

The patients Mr. Young recruited had to subject themselves to medically unnecessary tests to receive the money, according to plea documents. Per instructions from the owners and operators of Ritecare, Mr. Young admitted that he instructed the patients to claim they had certain symptoms to trigger medically unnecessary tests. Consequently, the patients' medical records contained false symptoms allowing Ritecare to deceive Medicare as to the legitimacy and medical necessity of the tests it performed.

Mr. Young admitted that he was responsible for recruiting at least 269 patients to Ritecare. Through his recruitment efforts, Mr. Young caused the submission of approximately $940,760 in false or fraudulent billings by Ritecare for the 269 patients he recruited. Medicare paid approximately $533,643 on those claims.

He faces a maximum penalty of 10 years in prison and a $250,000 fine. His sentencing has not yet been scheduled. Mr. Young's guilty plea follows that of another Ritecare recruiter, Hans Lobato.