Former Railroad Employee Sentenced to Two and a Half Years in Federal Prison for Fraudulently Obtaining Disability Benefits
CHICAGO — A federal jury has convicted the head of a Homewood telemarketing company of pocketing illegal kickbacks in exchange for referring patients to home health care agencies.
As the owner of Serenity Marketing Inc., which did business as Serenity Living, SUNDAE WILLIAMS used unsolicited phone calls to recruit patients, including Medicare beneficiaries, for home health care services. Williams then referred those patients to several Chicago-area nursing agencies in exchange for payments on a per-patient basis.
After a five-day trial in federal court in Chicago, the jury on Tuesday convicted Williams, 47, of South Holland, on one count of conspiracy to solicit and receive remuneration in return for the referral of Medicare patients, and six counts of soliciting and receiving remuneration in return for the referral of Medicare patients. Each count is punishable by up to five years in prison.
Williams is the latest defendant convicted in the federal investigation. The prior convictions include JAMES ADEMIJU, a nurse from Matteson who operated two suburban nursing agencies; Dr. ALAN NEWMAN, one of the doctors at Suburban Home Physicians, which did business as Doctor at Home; and DIANA JOCELYN GUMILA, a nurse and manager of Suburban Home Physicians.
The investigation is being carried out by the Medicare Fraud Strike Force, which is part of the Health Care Fraud Prevention & Enforcement Action Team, a joint initiative between the U.S. Justice Department and the U.S. Department of Health and Human Services to prevent fraud and to enforce anti-fraud laws around the country. Dozens of defendants have been charged in numerous fraud cases since the strike force began operating in Chicago in 2011.
Evidence at Williams’ trial revealed that Serenity employees were trained to cold-call Medicare beneficiaries and convince them to accept home health services. If a Medicare beneficiary expressed interest, Serenity employees obtained the beneficiary’s personal information, including their Medicare number, and provided it to certain home health agencies that had agreed to pay Serenity for such referrals.
Ademiju pleaded guilty earlier this year to billing for unnecessary services and making illegal payments for patient referrals. He testified at Williams’ trial that some of his illegal payments were made to Serenity. Ademiju also admitted in his plea agreement that he sent some of the patients he had illegally obtained from Serenity to home-physician companies, including Suburban Home Physicians, based on his belief that physicians at those companies would order home health services even if the patients did not qualify for them. Ademiju is awaiting sentencing.
Dr. Newman pleaded guilty earlier this year to falsely certifying patients for nursing services even when he knew that patients did not qualify for such care. He admitted causing approximately $2.6 million in losses to Medicare. Newman is awaiting sentencing.
Gumila, who was convicted after a jury trial in April, directed employees to provide in-home services to patients she knew were not in need of it, and to certify patients for home-health services even when the patients did not qualify for it. Gumila directed her employees to bill the treatment at the most complicated levels, thus inflating the costs incurred by Medicare, even though the visits were typically routine and did not qualify for the elevated billing. Gumila was sentenced last month to six years in prison.
Williams’ conviction was announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Lamont Pugh III, Special Agent-in-Charge of the Chicago Region of the U.S. Department of Health and Human Services Office of Inspector General; Michael J. Anderson, Special Agent-in-Charge of the Chicago Office of the Federal Bureau of Investigation; and Kristie Osswald, Special Agent-in-Charge of the Chicago Office of the Railroad Retirement Board Office of the Inspector General.
The government is represented in the Williams case by Assistant U.S. Attorneys Stephen Chahn Lee and Cornelius Vandenberg.