Wednesday, March 7, 2012

Home Health Care Fraud and Kickback Case Charges Two Doctors, Four Nurses and Employees in Illinois - Example of Federal Cases Being Filed

A recent home health care fraud case out of the Northern District of Illinois, United States v. Gabriel, et al., shows how these cases can grow over time and how referring physicians, nurses and non-medical employees are being added as defendants to these cases  An FBI press release has the details of the case.

In February 2011, Jacinto "John" Gabriel, Jr. was arrested and charged with a 15-count Indictment in the Northern District of Illinois relating to his alleged control and hidden ownership of two home health agencies: Perpetual Home Health, Inc. and Legacy Home Healthcare Services which purportedly billed for home health services that were not medically necessary or were never provided. Mr. Gabriel plead not guilty and is out on bond.  The two home health agencies allegedly received over $34 million over the years and restitution of $20 million is sought from the defendants.

A year later, March 7, 2012, 11 new defendants were added by way of a superseding Indictment. The details of the filing can be viewed in the press release but here is what is notable about the superseding Indictment.

First, the case has grown in scope over the year while the government has had time to investigate.

Second, two older physicians (ages 71 and 72) were charged with health care fraud and kickback counts. It appears that these physicians ordered the home health for the patients and at least one of them allegedly received kickbacks from the home health agencies.

Third, four nurses were charged but all of them were either part owners of the home health agencies or the daughter of the original defendant.

Fourth,  in an unusual move, lower level employees are being added. In this case two data entry employees and one quality assurance employee were added as defendants for falsifying patient records, among other things. In the past, these employees were treated as witnesses and not charged. However, the government is being more aggressive which should serve as a warning to employees working at medical businesses where there is a suspicion of fraud or abuse.

It was alleged that the owners and controlling defendants of the home health care agencies authorized kickback payments of of $200 to $800 to employees for each patient referred and enrolled in home health.  There are also money structuring (check cashing allegations of checks under $10,000), money laundering and income tax counts.


Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.  Any questions or comments  should be directed to Tracy Green, a very experienced health care fraud attorney and kickback attorney at tgreen@greenassoc.comThe firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers in criminal matters in California and throughout the country. Their website is: http://www.greenassoc.com/

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