CHICAGO—Two owners of a south suburban home health care business and a suspended podiatrist were arrested today on federal charges relating to alleged Medicare fraud in excess of $1.5 million and an alleged attempt to illegally obtain a work visa for one of the owners. At the same time, federal agents executed a search warrant at the business, House Call Physicians LLC, in Palos Hills. The defendants, Bahir Haj Khalil, the manager and co-owner of House Call; Mohammed Khamis Rashed, also co-owner of House Call; and Paschal U. Oparah, the suspended physician, were charged in a two-count criminal complaint that was filed yesterday and unsealed today in U.S. District Court following their arrests.
Khalil, 33, of Palos Hills, a native of Syria and a Canadian citizen who is not authorized to work in the U.S., and Oparah, 46, of South Holland, were charged with one count of health care fraud. Khalil and Rashed, 45,of Chicago, were charged with one count of visa fraud. All three are scheduled to appear at 1:15 p.m. today before U.S. Magistrate Judge Jeffrey Cole in Federal Court.
The arrests and charges were announced by Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois, together with Robert D. Grant, Special Agent in Charge of the Chicago Office of Federal Bureau of Investigation; 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; and James Vanderberg, Special Agent in Charge of the U.S. Department of Labor Office of Inspector General. The U.S. 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 complaint affidavit, the health care fraud scheme involved billing for services as if they were performed by physicians, when in fact they were performed by physician assistants; billing for podiatry services as if they were performed by a particular licensed podiatrist, when in fact they were performed by Oparah, whose license was suspended; and falsely certifying that patients were eligible for home health services, when in fact they were not homebound as required by Medicare, as well as causing medically unnecessary services to be provided to beneficiaries and billed to Medicare.
The visa fraud scheme alleges an attempt by Khalil and Rashed to obtain a visa for Khalil to work in the U.S. by misrepresenting that he was not already employed by, and did not own, House Call, and that the business intended to hire him as a home health aide earning $8.50 an hour.
The charges state that House Call was established in 2006 and enrolled in the Medicare program. The manager, Khalil, is not a licensed physician, podiatrist, physician assistant, registered nurse, or licensed practical nurse in Illinois. Between 2008 and the end of May 2011, Medicare reimbursed House Call more than $3.3 million based on approximately 36,864 claims for 2,348 separate beneficiaries. The charges rely, in part, on a former House Call physician, who recorded conversations with Khalil, and a physician assistant who cooperated with the investigation. The former physician provided information about House Call falsely certifying that patients were homebound and eligible for medicare coverage, in exchange for patient referrals from corrupt home health providers; ordering medically unnecessary tests, some of which were performed by unqualified staff; ordering medically unnecessary durable medical equipment; paying physicians for pro forma and cursory review of plans of care prepared by physician assistants; and billing services provided by physician assistants as if they were provided by medical doctors.
Between April 2008 and March 2011, House Call allegedly fraudulently obtained more than $1,150,000 in Medicare reimbursement for services billed under two physicians’ provider numbers. One of those physicians told agents that he/she was hired by Khalil and paid $2,000 a month to review and sign medical records prepared by physician assistants but was never required to see patients, according to the complaint affidavit.
In addition, House Call allegedly fraudulently obtained $463,000 from Medicare between 2008 and 2011 for services actually performed by Oparah, whose license was suspended in 2008, but which were billed as if the services had been performed by a different podiatrist, using that physician’s Medicare provider number.
Khalil, Rashed, and Oparah each obtained hundreds of thousands of dollars in payments from House Call over various periods since it was established, the charges allege.
Health care fraud and visa fraud each carry 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 the advisory United States Sentencing Guidelines.
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