Balitang America and Patch.com
By Ted Regencia
(Photo credit: Reuters)
SKOKIE, Ill — It is the largest health care fraud crackdown in U.S. history, according to Attorney General Eric Holder.
And here in Chicago, at least 13 individuals in the health care industry, including residents of Lincolnwood and Morton Grove, and employees of a shuttered Lincolnwood home health agency, are facing charges ranging from fraud to falsification of documents.
The Federal Bureau of Investigation charged on Thursday, February 17, a Chicago-area doctor, two chiropractors, three nurses, a pharmacist, and several home health staff.
They are among the 111 defendants from nine major U.S. cities; from Chicago to Miami, Detroit to Dallas. They are accused of illegally billing medicare, more than $225 million dollars.
“With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country,” Holder said.
“We have safeguarded precious taxpayer dollars. And we have helped to protect our nation’s most essential health care programs, Medicare and Medicaid,” he added.
The suspects from the Chicago area are also accused of offering or soliciting kickbacks in exchange for referrals of medicare patients.
While several sources confirmed that eight of them are originally from the Philippines, it is not clear whether they are American citizens or not.
One of them is Alona Dizon Bugayong, 35, of Lincolnwood. She was arrested February 17 and appeared before U.S. Magistrate Judge Jeffrey Cole in Chicago.
Bugayong allegedly “devised a scheme” with Han Woo, 35, of Hoffman Estates “to pay kickbacks in exchange for physician referrals of home health care patients.”
Woo operates New Covenant Home Health Agency LLC in Villa Park, and Healthquest Homecare LLC in Des Plaines, both mentioned in the FBI charge sheet.
A representative of Healthquest, who spoke in Filipino and English, pleaded for “privacy” and refused to be interviewed by this reporter.
Meanwhile, five individuals from Goodwill Home Healthcare are facing “criminal complaints” for “conspiracy to violate federal anti-kickback statute,” by agreeing to offer, pay, solicit or receive kickbacks for the referral of Medicare patients.
Marilyn Maravilla, 54, of Chicago; Junjee Arroyo, 42, of Elmurst; Ferdinand Echavia, 37, of Chicago; Kennedy Lomillo, 43, of Mundelein; and Baltazar Alberto, 47, of Morton Grove, were named as defendants. They were also arrested Thursday.
Goodwill’s Medicare billings raised suspicions, when it went up from $679,596 in 2008, to $2.13 million in 2009 and $2.7 million in 2010.
According to records seized by the FBI, an estimated $410,998 in kickbacks were paid to 28 persons, for referring 912 patients.
Goodwill’s last address was 7161 N. Cicero Avenue, Suite 2 in Lincolnwood. A check inside the building at the corner of Cicero and Estes revealed that it was no longer a tenant there.
Also arrested were Virgilio and Merigrace Orillo of Chalice Home Healthcare, which has offices in Chicago, Freeport and Morris. They reportedly falsified documents to increase payments received from Medicare, by making “patients appear to be sicker than they actually were.”
Dr. Jaswinder Rai Chhibber, 48, of Schaumburg who serves as president and owner of the Cottage Grove Community Medical Clinic in Chicago; and Dr. Andrew Carr, 41, a licensed Chiropractor from Lake in the Hills are also charged separately with one count of health care fraud each.
Two counts of health care fraud, on the other hand, were filed against Jay Hammermann, 62, a pharmacist; and Brandy Howard, 35, of Naperville.
Each count of health care fraud carries a maximum penalty of 10 years in prison and $250,000 fine.
A medical services company, U.S. Occupational Health, which performs physical and medical tests for private and government employees is charged with one count of mail fraud.
The FBI has not released photos of the accused, as they are presumed innocent until proven otherwise.
Kimberly Nerheim of the FBI said the investigation is on-going, with the special unit, HEAT Strike Force formed by Northern District of Illinois U.S. Attorney Patrick J. Fitzgerald, to investigate fraud.
“Paying for Medicare and Medicaid patients is a crime,” said Fitzgerald, who prosecuted former Illinois governors George Ryan and Rod Blagojevich. “We are focusing our resources on making sure that those who offer or solicit kickbacks are held accountable by the criminal justice system.”
There are over 1.3 million licensed medicare suppliers nationwide, with 18,000 new applications every month, according to news reports. Thus, enforcement against suspicious agencies is stalled.
The Obama administration is trying to correct that flaw.
U.S. Health and Human Services Secretary Kathleen Sebelius said the raid is part of the president’s effort to save taxpayer dollars.
“From 2008 to 2010, every dollar the Federal Government spent under its Health Care Fraud and Abuse Control programs averaged a return on investment of $6.80,” said Sebelius, adding that the government recovered $4 billion in 2010.