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According to a federal indictment returned in the Northern District of Illinois, the US Attorney’s Office, Northern District of Illinois, in a press release dated May 11, 2023, the operators of a suburban Chicago company, along with a social worker, allegedly engaged in a fraudulent scheme to unlawfully obtain over $1.16 million for medical billing fraud from Medicare.
This non-profit organization claimed to offer psychotherapy services to senior living facility residents in the Chicago area from 2019 to 2021. The indictment alleges that the couple conspired with a social worker to submit false claims to Medicare, falsely stating that residents had received individual psychotherapy sessions lasting one hour. According to the indictment, the defendants were reported aware that these services were not provided as claimed.
Execution of Medical Billing Fraud Scheme
To execute the scheme, one of the purportedly organized breakfast meetings for senior facility residents, often featuring guest speakers or group activities. These events were reportedly used to identify individuals whose Medicare information could be used to support the fraudulent claims. When the COVID-19 pandemic prevented in-person breakfasts, American Warriors reportedly collected residents’ phone numbers and billed Medicare for telehealth therapy sessions that were never actually conducted.
The charges against the defendants include health care fraud, and during their arraignments before US Magistrate Judge Gabriel A. Fuentes, all defendants pleaded not guilty. According to the indictment, American Warriors fraudulently obtained $1,164,624.61 through these claims.
7 Negative Consequences of Medical Billing Fraud
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