Local health care professionals caught in Medicare fraud sting
SUN-TIMES MEDIA WIRE May 14, 2013 1:54PM
Updated: May 14, 2013 2:06PM
A nationwide crackdown on Medicare and health care fraud has netted seven Chicago area residents, including two suburban doctors and three health clinic owners for separate plots that took in millions of dollars in fraudulent payments.
Two criminal complaints and two criminal informations filed Monday and Tuesday in U.S. District Court in Chicago, and an indictment unsealed following the arrest of one defendant in Miami, charged a total of seven people, according to the U.S. Attorney’s office.
The seven are charged with health care fraud for defrauding the Medicare program or violating its anti-kickback statute for referrals of Medicare patients, according to a statement from federal prosecutors.
Among those charged in U.S. District Court in Chicago were Ankash Patel, 33, of Morton Grove; Dipen Desai, 33 of Chicago, and Ankur Roy, 36, of Miami, who owned and operated Selectcare Health in Park Ridge and Skokie. They are charged with submitting more than $4 million in false billings to Medicare between March and July 2011.
The three are charged with submitting false claims to Medicare and Blue Cross Blue Shield on behalf of patients for respiratory therapy services that were never provided, including some for whom they billed for treatment seven days a week, federal prosecutors allege. The indictment seeks forfeiture of $2,535,305, including $446,974 in cashiers’ checks seized by the FBI in July 2012.
Dr. Cecelia Ibrahim, 50, of Frankfort was also charged for defrauding Medicare and private insurance compamies of about $1.7 million through her Sunrise Medical Center in Flossmoor, prosecutors allege. Between March 2006 and August 2009, she submitted more than 3,200 false claims for spinal decompression neuroplasty, a procedure that she did not perform. The indictment seeks forfeiture of at least $882,500.
Ellyse Lamon, 30, of Elmhurst, is charged with a $350,000 false billing scheme involving Medicare. An account executive at a company that sold durable medical equipment, including back braces and electrical nerve stimulation units, her scheme involved false claims stating a physician had prescribed the equipment when they did not, and the equipment was not medicall necessary. She allegedly forged doctors’ signatures and created false treatment records, using patient information she inappropriately accessed at a pain medicine center in Chicago.
Dr. Nalini Ahluwalia, 58, of Burr Ridge, is charged with violating the anti-kickback law for receiving $1,000 for referring two patients to a home health care agency in August 2012. A confidential informat told the FBI they paid kickbacks to Ahluwalia of $400 to $500 for her referral of Medicare patients to a home health care company, according to prosecutors.
On Aug. 23, 2012, the CI met with Ahluwalia at her office in Chicago, and paid $1,000 for two more Medicare patient referrals, a transaction caught on audio/video recording, according to the complaint affidavit. In October 2012 and February 2013, two more $500 payments were made for referrals, prosecutors allege.
Joseph Dickson, 65, of Lansing, is charged with receiving $4,200 for referrals to a home health care agency in October 2012. The owner of JD Medical Consultants had also previously made about 30 illegal referrals for about $15,000 between 2006 and 2008, the complaint alleges. On Oct. 30, 2012, a CI recorded him accepting $4,200 for seven referrals; and an additional $1,800 in December 2012 for additional referrals.
Four of the five local cases were part of a nationwide operation led by the Medicare Fraud Strike Force in eight cities, which led to charges against 89 people, including doctors, nurses, and other medical professionals, for fraud schemes that took in as much as $233 million in false billings, the statement said.
“Today’s charges are part of our continuing efforts not only to deprive dishonest healthcare providers of their illegal profits, but to demonstrate to the broader medical services community that healthcare fraud will be found out and prosecuted with all of our resources,” U.S. Atty. Gary Shapiro said in the statement.