Press Releases
Chicago U.S. Attorney’s Office Creates Unit to Prosecute Healthcare Fraud
CHICAGO — Joel R. Levin, Acting United States Attorney for the Northern District of Illinois, today announced the creation of a new unit dedicated to the prosecution of criminal health care fraud violations. The newly created Health Care Fraud Unit will operate within the office’s Criminal Division. The unit will be tasked with prosecuting defendants in all types of health care fraud, from providers who engage in fraudulent billing schemes to doctors who falsify patients’ diagnoses to justify expensive tests or procedures that aren’t medically necessary.
CHICAGO — Joel R. Levin, Acting United States Attorney for the Northern District of Illinois, today announced the creation of a new unit dedicated to prosecuting criminal healthcare fraud violations.
The Health Care Fraud Unit will operate within the office’s Criminal Division. The unit will prosecute defendants in all types of healthcare fraud, from providers who engage in fraudulent billing schemes to doctors who falsify patients’ diagnoses to justify expensive tests or procedures that aren’t medically necessary.
“Every year, healthcare fraud causes millions of dollars in losses to Medicare and private insurers,” said Acting U.S. Attorney Levin. “Health care fraud also often exploits patients through unnecessary or unsafe medical procedures. Healthcare providers who cheat the system must be held accountable. Our office has successfully prosecuted numerous healthcare fraud cases in recent years. The new Health Care Fraud Unit will build on that success and bring greater focus, efficiency, and impact to our efforts in this important area.”
The unit will include five prosecutors, led by Assistant U.S. Attorney Heather McShain. Assistant U.S. Attorney Stephen Chahn Lee will serve as the unit’s Senior Counsel.
The office has a long history of prosecuting significant healthcare fraud cases, and the new unit is expected to expand on those efforts. Last week, the office participated in the most critical healthcare fraud enforcement action in the Department of Justice's history. The national takedown involved more than 400 defendants, including 15 individuals charged in the Northern District of Illinois.
Other significant healthcare fraud prosecutions include a north suburban chiropractor and his brother and father, who were sentenced to prison with a phony billing scheme that bilked insurance carriers out of over $10.8 million. DR. VLADIMIR GORDIN JR., VLADIMIR GORDIN SR., and ALEXSANDER GORDIN used their chiropractic clinic, Gordin Medical Center S.C., to falsely bill for medical services that were either not provided or weren’t medically necessary. The Gordins were sentenced to prison terms earlier this year. Vladimir Gordin Jr. was sentenced to seven years; Vladimir Gordin Sr. was sentenced to two and a half years; and Alexsander Gordin was sentenced to two years.
The office recently secured ten criminal convictions in a multi-year investigation into Sacred Heart Hospital in Chicago. For over a decade, Sacred Heart executives conspired to pay kickbacks and bribes to physicians to induce them to refer patients for services that Medicare and Medicaid would reimburse. The fraud scheme earned Sacred Heart millions of dollars from Medicare and Medicaid. The convictions include EDWARD NOVAK, the hospital’s owner and chief executive officer; ROY PAYAWAL, the chief financial officer; CLARENCE NAGELVOORT and ANTHONY J. PUORRO, chief operating officers; DR. VENKATESWARA R. “V.R.” KUCHIPUDI, a physician; as well as four other physicians. Sacred Heart closed in 2013.
Fraud in the home healthcare and hospice industries have also been the subject of prosecutions, and the Health Care Fraud Unit will continue those efforts. The office’s investigation of home healthcare fraud has resulted in convictions of doctors, nurses, marketers, and executives at multiple companies, including DIKE AJIRI, the former owner of Chicago-based Mobile Doctors; BANIO KOROMA, a physician at Mobile Doctors; and DIANA JOCELYN GUMILA, the former clinical head of Schaumburg-based Doctor at Home. An investigation of PASSAGES HOSPICE in Lisle recently resulted in prison sentences for multiple defendants, including owner SETH GILLMAN, who was sentenced earlier this year to six and a half years in prison; and ANGELA ARMENTA, Passages’ former director of certified nursing assistants, who was sentenced last month to 20 months in jail.
The Health Care Fraud Unit will also focus on prosecutions related to the diversion of controlled substances, which is an area of emphasis for the office as it continues to battle the opioid crisis. The office has previously prosecuted significant diversion cases, including procuring the guilty plea of DR. SATHISH NARAYANAPPA BABU, who formerly owned Anik Life Sciences Medical Corp. in southwest suburban Darien. Dr. Babu prescribed controlled substances, including OxyContin and Hydrocodone, to specific patients without having examined them. Dr. Babu was sentenced in 2015 to 18 months in prison.
In announcing the new unit, Acting U.S. Attorney Levin acknowledged the cooperation and determination of the office’s investigative partners, including, among others, the Chicago offices of the Federal Bureau of Investigation, U.S. Department of Health and Human Services Office of Inspector General, U.S. Department of Labor’s Office of Inspector General, U.S. Food and Drug Administration, and U.S. Postal Inspection Service.
About Stephen Lee Law
At the heart of every press release from the Law Offices of Stephen Chahn Lee lies a diverse and illustrious career that traverses the realms of journalism, law, and medicine with precision. From a pre-med student to a respected journalist, a lawyer at a premier New York firm, and an influential federal prosecutor, Stephen Lee's unique journey underpins the profound insights and captivating storytelling that define the firm's communications. Since founding his solo practice in 2022, Lee has tackled complex, high-stakes legal matters with the enthusiasm that marked his tenure at Debevoise & Plimpton LLP and his decisive victories as an Assistant United States Attorney. His firm's press releases are more than just news; they are narratives enriched by his comprehensive legal expertise, commitment to justice, and active community engagement. In Chicago, where he practices, writes, and volunteers, Lee strives for a positive impact beyond the courtroom.
For further insights into Stephen’s background as a U.S. Assistant Attorney or for legal guidance with healthcare fraud defense, please contact Stephen Lee Law.
Historically Largest National Medicare Fraud Takedown Sees 12 Charged in Chicago
CHICAGO – Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide takedown by Medicare Fraud Strike Force operations in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount. Zachary T. Fardon, United States Attorney for the Northern District of Illinois, announced thirteen defendants who were charged in four local cases as part of the national package.
CHICAGO – Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide takedown by Medicare Fraud Strike Force operations in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended several providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history; regarding the number of defendants charged and loss amount, Zachary T. Fardon, United States Attorney for the Northern District of Illinois, announced thirteen defendants charged in four local cases as part of the national package.
“This action represents the largest criminal health care fraud takedown in the history of the Department of Justice, and it adds to an already remarkable record of enforcement,” said Attorney General Lynch. “The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners, and others. They billed for equipment that wasn’t provided, care that wasn’t needed, and services that weren’t rendered. In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives. We are prepared – and I am personally determined – to continue working with our federal, state, and local partners to bring about the vital progress that all Americans deserve.”
“Health care fraud extracts a huge toll on our nation’s health care system,” stated U.S. Attorney Fardon, announcing the cases charged in the Northern District of Illinois. We will continue aggressively pursuing those health care providers who take advantage of the system and the patients they are entrusted to care for.”
Three cases and nine defendants in the Northern District of Illinois involve home health services. This area is “vulnerable to fraud, waste, and abuse,” according to the Department of Health and Human Services Office of Inspector General in a 2012 report, “Inappropriate and Questionable Billing by Medicare Home Health Agencies.” In 2013, citing factors that strongly indicated fraudulent activity in the metropolitan Chicago area compared to other places, the Centers for Medicare & Medicaid Services imposed the first-ever moratorium authorized by the Affordable Care Act to halt the enrollment of new home health providers in the metropolitan Chicago area.
The Medicare Fraud Strike Force operations 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 on preventing and deterring fraud and enforce current anti-fraud laws around the country Since their inception in March 2007, Strike Force operations in nine locations have charged over 2,300 defendants who collectively have falsely billed the Medicare program for over $7 billion.
Including today’s enforcement actions, nearly 900 individuals have been charged in national takedown operations, which have involved more than $2.5 billion in fraudulent billings. Today’s announcement marks the first time that districts outside of Strike Force locations have participated in a national takedown; those districts account for 82 defendants charged in the takedown.
The cases announced today are being prosecuted and investigated by Medicare Fraud Strike Force teams from the Fraud Section of the Justice Department’s Criminal Division and the U.S. Attorney’s Offices for the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois, and the Middle District of Florida; and agents from the FBI, HHS-OIG and state Medicaid Fraud Control Units.
In addition to the Strike Force, today’s enforcement actions include cases brought by the U.S. Attorney’s Offices for the Northern District of Illinois, Southern District of Illinois, Northern District of Ohio, Western District of Pennsylvania, Western District of Kentucky, Southern District of New York, Alaska, and the Southern District of Georgia The following cases are being prosecuted by the Northern District of Illinois:
United States vs. Janet Guerrero et al.
Seven individuals who worked at three related home health care companies – Donnarich Home Health Care, Inc., Josdan Home Health Care Inc., and Pathways Home Health Services LLC – were charged by superseding indictment yesterday with conspiracy to commit health care fraud, health care fraud, false statements, and money laundering The indictment alleges a $45 million fraud at the three home health care companies, starting as early as 2008 and continuing into 2014 The fraud as alleged included paying illegal bribes and kickbacks to obtain Medicare beneficiaries; ignoring doctors who refused to certify beneficiaries as “homebound” and eligible for care; enrolling patients who did not need or want the care; subjecting patients to pre-planned cycles of discharges and re-enrollments, regardless of their medical needs; and falsifying medical records to make patients appear to be homebound or sicker than they were.
The newly charged defendants include Josephine Tinimbang, an owner and operator of the companies; Dr. Jose Calub, the medical director; Sharon Gulla, a registered nurse and a former supervisor; and Marilou Lozano, Ronald Malalis, Mary Pilar Mendoza, and Isabelita Sabejon, registered nurses who enrolled non-homebound beneficiaries and fabricated medical records Two defendants were charged in an earlier indictment: Sherwin Cubelo, a patient recruiter who received illegal kickbacks; and Janet Guerrero, an office manager who administered the kickbacks The government is represented in this case by Trial Attorney Brooke Harper.
United States vs. Barry Fischer
Barry Fischer, 70, of River Forest, was indicted for health care fraud on Wednesday in a 20-count federal indictment for allegedly billing Medicare for unnecessary home visits for falsely certifying patients for home health services. For putting false information in patient charts, Fischer allegedly signed orders in which he falsely certified patients as “confined to the home,” under his care, and requiring skilled nursing services. According to the indictment, due to Fischer’s false certifications, Medicare suffered losses in payments to the company Fischer worked for and various home health agencies. Assistant U.S. Attorney Stephen Chahn Lee represents the government in this case.
United States vs. Zenaida Dimailig
Zenaida Dimailig, 78, of Bensenville, was charged by complaint with health care fraud for allegedly causing Medicare to be billed for home health services for patients who were not homebound and for services that were not rendered. Dimailig reportedly paid cash kickbacks to Medicare-covered patients who, in turn, allowed their Medicare information to be used to bill Medicare for home health services that these individuals did not need. Dimailig then passed on this Medicare information and records that falsely suggested that certain services were provided to Medicare beneficiaries to home healthcare agencies to bill Medicare. The government is represented in this case by Assistant U.S. Attorney Timothy Storino.
United States vs. Omeed Memar
Omeed Memar, 46, of Chicago, a dermatologist, was indicted for health care fraud last week in a 16-count federal indictment for allegedly billing cosmetic treatments fraudulently as the destruction of large numbers of precancerous lesions. According to the indictment, the defendant falsely diagnosed patients with actinic keratosis, or precancerous lesions that are typically rough, dry, or scaly, and then billed public and private health insurers for medically unnecessary treatments. According to the indictment, between 2007 and January 2013, Memar falsely diagnosed patients with actinic keratosis ordered his staff to provide intense-pulsed light treatments for his patients, and instructed his staff to document the procedures falsely as the destruction of 15 or more precancerous lesions. Assistant U.S. Attorney Stephen Chahn Lee represents the government in this case.
The charges were announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Robert J. Holley, Special Agent-in-Charge of the Chicago Office of the Federal Bureau of Investigation; Lamont Pugh III, Special Agent-in-Charge of the U.S. Department of Health and Human Services Office of Inspector General in Chicago; James Vanderberg, Special Agent-in-Charge of the U.S. Department of Labor Office of Inspector General in Chicago; Martin J. Dickman, Inspector General, U.S. Railroad Retirement Board; and Stephen Boyd, Special Agent-in-Charge of the Internal Revenue Service, Criminal Investigation, Chicago Field Office.
Money laundering carries a maximum penalty of 20 years in prison and a $500,000 fine. Healthcare fraud and conspiracy to commit healthcare fraud carry a maximum penalty of 10 years in prison and a $250,000 fine, and restitution is mandatory. Making a false statement in a healthcare matter carries a maximum penalty of 5 years in prison and a $250,000 fine. The court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines if convicted.
The public is reminded that indictments and complaints 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.
About Stephen Lee Law
At the heart of every press release from the Law Offices of Stephen Chahn Lee lies a diverse and illustrious career that traverses the realms of journalism, law, and medicine with precision. From a pre-med student to a respected journalist, a lawyer at a premier New York firm, and an influential federal prosecutor, Stephen Lee's unique journey underpins the profound insights and captivating storytelling that define the firm's communications. Since founding his solo practice in 2022, Lee has tackled complex, high-stakes legal matters with the enthusiasm that marked his tenure at Debevoise & Plimpton LLP and his decisive victories as an Assistant United States Attorney. His firm's press releases are more than just news; they are narratives enriched by his comprehensive legal expertise, commitment to justice, and active community engagement. In Chicago, where he practices, writes, and volunteers, Lee strives for a positive impact beyond the courtroom.
For further insights into history's largest national medical fraud takedown or legal guidance with healthcare fraud defense, please contact Stephen Lee Law.