$3 Million Healthcare Fraud Case In Chicago
Three Chicago doctors indicted for cashing in nearly $3 million in fraudulent reimbursements
Despite reports feds are cracking down on EHR Incentive fraud, more cases are popping up. Health IT Outcomes explains, "The EHR Incentive Program is a way to provide cash incentives to qualifying providers which successfully attested to MU, however some providers have been caught taking advantage of the program."
Most recently, "Three healthcare professionals and three accomplices posing as patients have been indicted in Illinois for allegedly cashing in on nearly $3 million in fraudulent reimbursements for services that were never performed," reports EHR Intelligence. A chiropractor, physician, and billing manager for their practice "were each accused of 16 counts of mail fraud, as well as charges of obstruction of justice and making false statements, for their role in illegally obtaining insurance payments." There were three patients who allowed these individuals to use their personal information and identities "as the basis for the false claims."
Because of this incident, United Healthcare, Blue Cross Blue Shield of Illinois, Aetna, and Allstate all suffered losses. This incident "involved the providers paying the fake patients a portion of the money received, or arranging to have their insurance deductibles satisfied in exchange use of for their personal details." The patients were also asked to lie about the services they received. "The state is seeking forfeit of $2.98 million in cash, four luxury cars, office space, and five residences belonging to the two main defendants."
EHR Intelligence also reported in January, "The New Year may be about a week old, but it has already seen a large number of healthcare fraud allegations from across the country. While some cases have ended in settlements, others are sending the defendants to prison." These cases included New Jersey lab scheme with Dr. Joel Fischgrund, Total Care Services paying out $187,500 for fake Medicaid claims, and the owner of Peaceful Alternative Resources, Inc. pleading guilty to charges of healthcare fraud.