National Healthcare Fraud Takedown Results in Charges Against More Than 400 Individuals, Including Several Chicago-Area Medical Professionals
CHICAGO — Several Chicago-area medical professionals, including two licensed physicians, are facing federal criminal charges as part of the largest health care fraud enforcement action in Department of Justice history, federal authorities announced today.
The national enforcement action taken by the Medicare Fraud Strike Force involved more than 400 defendants charged in 41 federal districts across the country, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. More than 20 state Medicaid Fraud Control Units participated in today’s arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to 295 providers, including doctors, nurses and pharmacists.
The national enforcement action was announced by U.S. Attorney General Jeff Sessions and U.S. Department of Health and Human Services Secretary Tom Price, M.D., along with Acting Assistant U.S. Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division; Acting Federal Bureau of Investigation Director Andrew McCabe; Acting Drug Enforcement Administration Administrator Chuck Rosenberg; Inspector General Daniel Levinson of the HHS Office of Inspector General (OIG); IRS-Criminal Investigations Chief Jon Fort; CMS Administrator Seema Verma; and Deputy Director Kelly P. Mayo of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division Fraud Section’s Health Care Fraud Unit, in conjunction with its Medicare Fraud Strike Force partners – a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, and State Medicaid Fraud Control Units.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Attorney General Sessions. “While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
Several Chicago-area medical professionals, including two doctors, were charged as part of investigations in the Northern District of Illinois, announced Joel R. Levin, Acting United States Attorney for the Northern District of Illinois; Michael J. Anderson, Special Agent-in-Charge of the Chicago office of the FBI; Gabriel L. Grchan, Special Agent-in-Charge of the IRS Criminal Investigation Division in Chicago; and Lamont Pugh III, Special Agent-in-Charge of the Chicago Regional Office of the U.S. Department of Health and Human Services Office of Inspector General.
“Health care fraud is a serious crime that can have devastating consequences,” said Acting U.S. Attorney Levin. “Our office will continue to vigorously investigate and prosecute those who seek to enrich themselves through fraudulent health care schemes.”
“This week, we arrested once trusted doctors, nurses, and other medical professionals who were corrupted by greed and preyed on the vulnerable utilizing them to bill for services or drugs that were unnecessary or never provided,” said FBI Chicago Special Agent-in-Charge Anderson.
One of the Illinois cases involved BEATTA KABBANI, a licensed physical therapist, who was charged in a 13-count indictment with health care fraud and aggravated identity theft. Kabbani is the owner of MedCare Medical Group in Glenview. The indictment charges Kabbani with submitting more than $2 million in false claims to Blue Cross Blue Shield of Illinois and United Health Care. The charges state that Kabbani used a physician’s National Provider Identification number to substantiate some of those false claims. Kabbani is scheduled to be arraigned on July 26, 2017, before U.S. District Judge Gary Feinerman. The Kabbani case is being handled by Assistant U.S. Attorneys Heather McShain and Matthew Kutcher.
Another Illinois case involved JEFFREY WITEK and STEPHEN HOESLEY, licensed chiropractors who were charged in an 18-count indictment with health care fraud. The charges stem from their alleged participation in a scheme to defraud Blue Cross Blue Shield of Illinois. Witek and Hoesley submitted at least approximately $1.1 million in fraudulent claims to Blue Cross Blue Shield of Illinois that falsely represented that certain health care services were provided to patients, knowing that those services were not actually provided. Witek and Hoesley are scheduled to be arraigned on Aug. 2, 2017, before U.S. District Judge Matthew F. Kennelly. The Witek and Hoesley case is being handled by Special Assistant U.S. Attorney Jared Jodrey.
One of the Illinois investigations involved multiple medical professionals. ZOSIMA VICTUELLES, MYLENE MASICLAT, MARIBEL CABRERA, YASEEN ODEH and MOHAMMAD RAZA KHAN were charged in a 28-count indictment with conspiracy to offer and pay, and to solicit and receive, kickbacks and bribes for the referral of Medicare beneficiaries to Sure Care Home Health Corp. The indictment also charges substantive violations of the anti-kickback statute. Victuelles, Masiclat and Cabrera were the owners of Sure Care, a home health agency with offices in Glendale Heights and Rockford. Victuelles and Cabrera are also licensed nurses, while Odeh and Khan are licensed medical doctors. The charges stem from Victuelles, Masiclat, Cabrera and others paying Dr. Odeh, Dr. Khan and others more than $435,000 in kickbacks and bribes for the referral of Medicare beneficiaries to Sure Care. Arraignments in federal court in Chicago have not yet been scheduled. The case is being handled by Assistant U.S. Attorney Matthew Madden.
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged more than 3,500 defendants who collectively have falsely billed the Medicare program for more than $12.5 billion.
The public is reminded that an indictment is merely an allegation, and all defendants are presumed innocent until proven guilty.