Bryan Day Charged by a Federal Grand Jury in an Indictment Alleging a $1 Million Medicare Fraud Scheme

May 2, 2012

The Federal Bureau of Investigation (FBI) on May 2, 2012 released the following:

“Chicago-Area Man Charged in $1 Million Medicare Fraud Scheme

CHICAGO— A south suburban resident who purported to provide psychotherapy services to Medicare patients was charged with participating in a $1 million health care fraud scheme, the Departments of Justice and Health and Human Services announced today.

The defendant, Bryan Day, 42, of Richton Park, who is not a licensed medical professional, operated and was part owner of Charm Development LLC, located in Chicago Heights, which purported to provide psychotherapy services to patients, primarily in nursing homes and long-term care facilities. Day was charged with six counts of health care fraud in an indictment returned by a federal grand jury last week and announced today by Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois; Lamont Pugh III, Special Agent in Charge of the Chicago Regional Office of the HHS-OIG; and Robert D. Grant, Special Agent in Charge of the Chicago Office of the Federal Bureau of Investigation.

Day is scheduled to be arraigned at 1:30 p.m. May 14 before U.S. District Judge Virginia Kendall in federal court in Chicago.

The indictment alleges that between January 2008 and June 2009 Day submitted fraudulent claims to Medicare totaling $1,078,733, and caused Medicare to pay approximately $438,852. Day allegedly submitted claims for individual psychotherapy services purportedly performed by Doctor A, knowing that Doctor A did not provide the services claimed. In addition, the claims included services that were purportedly provided at times when Doctor A was not present at Charm and not licensed by the state of Illinois. The claims also included services that were purportedly provided by Doctor A after Doctor A was no longer employed by Charm, and Day allegedly submitted Medicare claims for services purportedly rendered by Doctor A in excess of 24 hours a day.

According to the indictment, Doctor A was licensed to practice medicine in Illinois until July 31, 2008, and Doctor A was employed by Charm from May 2005 until February 2009.

The indictment seeks forfeiture of approximately $438,852. The government is represented by Assistant U.S. Attorney Michael J. Chmelar. Each count of health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine, or an alternate fine totaling twice the loss or twice the gain, whichever is greater. If convicted, the court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.

An indictment contains merely charges and is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.

The case is part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that led to charges against 107 individuals for their alleged participation in schemes to collectively submit approximately $452 million in fraudulent claims to Medicare. This takedown involved the highest amount of false Medicare billings in a single takedown in Strike Force history.

“The results we are announcing today are at the heart of an Administration-wide commitment to protecting American taxpayers from health care fraud, which can drive up costs and threaten the strength and integrity of our health care system,” said Attorney General Eric Holder. “We are determined to bring to justice those who violate our laws and defraud the Medicare program for personal gain. As today’s takedown reflects, our ongoing fight against health care fraud has never been more coordinated and effective.”

The Medicare Fraud Strike Force operations, which expanded to Chicago in February 2011, are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 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. Approximately three dozen defendants have been charged in health care fraud cases since the strike force began operating in Chicago last year.

Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

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To find additional federal criminal news, please read Federal Criminal Defense Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition Defense, OFAC SDN Sanctions Removal, International Criminal Court Defense, and US Seizure of Non-Resident, Foreign-Owned Assets. Because we have experience dealing with INTERPOL, our firm understands the inter-relationship that INTERPOL’s “Red Notice” brings to this equation.

The author of this blog is Douglas C. McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Fidelis Ogbu and Neacacha Joyner Were Indicted by a Federal Grand Jury Alleging Federal Criminal Charges of Extortion and Bribery

March 7, 2012

The Federal Bureau of Investigation (FBI) on March 6, 2012 released the following:

“Two DeKalb County Public Works Officials Indicted for Extortion and Bribery

Private Construction Contractor Forced to “Pay to Play”

ATLANTA—FIDELIS OGBU, 59, and NEACACHA JOYNER, 40, both of DeKalb County, Georgia, were indicted today on federal charges of extortion and bribery. They are expected to be arraigned before United States Magistrate Judge Gerrilyn G. Brill later this week.

United States Attorney Sally Quillian Yates said, “The citizens of DeKalb County are entitled to employees who serve the public, not extort them. We will continue to vigorously prosecute public employees who abuse the public’s trust to line their own pockets.”

Brian D. Lamkin, special agent in charge, FBI Atlanta Field Office, stated, “The actions of the defendants, as alleged in this indictment, serve as the core definition of public corruption. Public officials who attempt to personally profit from others who are merely trying to engage the government in otherwise legitimate business will not be tolerated and the FBI will continue its efforts in identifying, investigating, and presenting for prosecution those individuals engaged in such activity.”

According to United States Attorney Yates, the charges, and other information presented in court: OGBU (an engineering supervisor) and JOYNER (a construction inspector) allegedly exploited their positions with the DeKalb County Department of Public Works to extort money from a private contractor hired to work on a sidewalk construction project. OGBU and JOYNER are charged with executing a “pay to play” scheme, in which they compelled the contractor to pay them off in order for the contractor to complete the project, to avoid unnecessary work delays, and to gain future projects.

On March 6, 2012, a federal grand jury returned separate indictments charging OGBU and JOYNER with extortion and bribery. The most serious of the charges (extortion) carries a maximum sentence of 20 years in prison and a fine of up to $250,000. In determining the actual sentence, the court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.

Members of the public are reminded that the indictment only contains charges. The defendant is presumed innocent of the charges and it will be the government’s burden to prove the defendant’s guilt beyond a reasonable doubt at trial.

This case is being investigated by special agents of the Federal Bureau of Investigation.

Assistant United States Attorney Jeffrey W. Davis is prosecuting the case.”

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Douglas McNabb – McNabb Associates, P.C.’s
Federal Criminal Defense Attorneys Videos:

Federal Crimes – Be Careful

Federal Crimes – Be Proactive

Federal Crimes – Federal Indictment

Federal Crimes – Detention Hearing

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To find additional federal criminal news, please read Federal Crimes Watch Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition and OFAC SDN Sanctions Removal.

The author of this blog is Douglas McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.


Operation of Two Home Health Care Businesses Indicted in Alleged $20 Million Medicare Fraud Scheme

June 30, 2011

U.S. Attorney’s Office Northern District of Illinois on June 29, 2011 released the following press release:

“CHICAGO — A Chicago man who operated two home health care businesses, one of which was among the state’s largest recipients of Medicare payments, was indicted on federal fraud charges for allegedly swindling Medicare of at least $20 million over five years, federal law enforcement officials announced today. The defendant, Jacinto “John” Gabriel, Jr., allegedly schemed with others to submit millions of dollars in false claims for reimbursement of home healthcare services purportedly provided to Medicare beneficiaries, which allegedly were never provided, were not medically necessary, or were inflated in price so that he and others could profit from the fraudulently-obtained funds. Gabriel and his co-schemers allegedly used the proceeds for various purposes, including: using more than $5.5 million in cash to maintain lavish lifestyles, including gambling at casinos in the Chicago area and Las Vegas, and to buy automobiles, jewelry and real estate in the United States and the Philippines; to perpetuate the businesses by paying his employees and providing them with gifts, and to bribe physicians and pay kickbacks to others in exchange for patient referrals.

Gabriel, 43, who had no formal medical training, medical degrees, nor licenses to practice as a health care professional, was charged with two counts of wire fraud, two counts of health care fraud and 11 counts of money laundering in a 15-count indictment returned yesterday by a federal grand jury, announced Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois. The indictment also seeks forfeiture of $20 million. He has remained free on bond since he was arrested on preliminary charges in February and he will be arraigned on a date still be determined in U.S. District Court.

“The fraud alleged in this indictment illustrates complete disregard of the needs and interests of Medicare patients,” said 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. “The OIG is determined to aggressively investigate Medicare fraud and will continue to work with our law enforcement partners to ensure that those who perpetrate these types of crimes are held accountable.”

Mr. Fitzgerald and Mr. Pugh announced the charges together with Robert D. Grant, Special Agent-in-Charge of the Chicago Office of Federal Bureau of Investigation, and Alvin Patton, Special Agent-in-Charge of the Internal Revenue Service Criminal Investigation Division. The Railroad Retirement Board Office of Inspector General also participated in the investigation, which is continuing. The investigation is being conducted by the Medicare Fraud Strike Force, which expanded to Chicago earlier this year, and is part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative between the Justice Department and HHS to focus their efforts to prevent and deter fraud and enforce anti-fraud laws around the country.

According to the indictment, Gabriel did not identify himself as an owner, but in fact exercised ownership and control over Perpetual Home Health, Inc., based in Oak Forest, and Legacy Home Healthcare Services, which was located on the city’s north side. Both firms have ceased operating and no longer receive Medicare payments. Between May 2006 and January 2011, Perpetual submitted more than 14,000 Medicare claims seeking reimbursement for services allegedly provided to beneficiaries. As a result of those claims, Perpetual received more than $38 million in Medicare payments, making it one of the largest, if not the largest, recipients of Medicare payments for home health services in Illinois. Between 2008 and January 2011, Legacy submitted more than 2,000 claims for Medicare reimbursement and received more than $5 million.

As part of the fraud scheme, Gabriel and his co-schemers allegedly obtained personal information of Medicare beneficiaries to bill Medicare without the beneficiaries’ knowledge or consent; created false patient files to support fraudulent Medicare claims and submitted false claims based on those records; used Medicare proceeds to pay himself, co-schemers, employees, and others who assisted him in carrying out the scheme; and concealed the fraud proceeds by directing Perpetual and Legacy to issue checks payable to fictitious entities, his friends and associates.

Among other details, the indictment alleges that Gabriel authorized Perpetual and Legacy to pay various amounts, ranging between $200 and $800, to employees and others for each patient they referred and enrolled in home healthcare services. He and others also cold-called Medicare beneficiaries to try to persuade them to enroll with Perpetual and Legacy.

As part of allegedly falsifying patient records, Gabriel directed Perpetual and Legacy personnel to systematically complete standard forms by listing the same false diagnoses, including arthropathy (joint disease) and hypertension, which enabled them to claim a higher level of Medicare reimbursement, according to the charges.

In addition to the fraud counts, the money laundering charges allege that between last October and December, Gabriel cashed 11 checks in amounts under $10,000 — usually $9,000 and all involving fraud proceeds — to avoid federal currency transaction reporting requirements.

Each count of wire fraud and money laundering carries a maximum penalty of 20 years in prison, while each count of health care fraud carries a maximum 10-year prison term. Each wire fraud and healthcare fraud count carries a maximum fine of $250,000, or an alternate fine totaling twice the loss or twice the gain, whichever is greater. Each money laundering count carries a maximum fine of $500,000. If convicted, the Court must impose a reasonable sentence under the advisory United States Sentencing Guidelines.

The public is reminded that charges are not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.”

To find additional federal criminal news, please read The Federal Crimes Watch Daily.

Douglas McNabb and other members of the U.S. law firm practice and write extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition and OFAC SDN List Removal.

The author of this blog is Douglas McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.

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