6 Filipinos indicted in US Medicare fraud case
US Federal Law Officials indicted 11 new defendants among them several Filipinos in Illinois to a federal indictment alleging they were part of a group defrauding Medicare of at least $20 million over the past five years.
Federal officials allege the 11 new defendants conspired with the initial defendant, Jacinto “John” Gabriel, to submit millions of dollars in false claims for reimbursement of home health care services purportedly provided to Medicare beneficiaries, which allegedly were never provided or were not medically necessary so that they could profit from the fraudulently-obtained funds.
“Gabriel and his co-schemers allegedly used the proceeds for various purposes, including using cash to gamble at casinos in the Chicago area and Las Vegas; to buy automobiles, jewelry; to purchase 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,” the US Department of Justice said in a statement.
The 44-year-old Gabriel has been charged with one count of health care fraud conspiracy, 43 counts of health care fraud, 11 counts of money laundering, and four counts of federal income tax evasion, said Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois.
Gabriel, who was arrested and charged in February 2011, pleaded not guilty.
Six of the 11 new defendants added to Gabriel’s case are Filipino, reports said.
The Filipino defendants are:
- Jassy Gabriel, 42, John Gabriel’s brother, and a registered nurse. He was charged with one count of health care fraud conspiracy and one count of filing a false federal income tax return.
- Stella Lubaton, 46, a minority owner of Perpetual and an officer and administrator, as well as a registered nurse. She was charged with one count of health care fraud conspiracy, 16 counts of health care fraud, one count of filing a false federal income tax return, and one count of violating the medical anti-kickback statute.
- Nessli Reyes, 35, a registered nurse. She was charged with one count of health care fraud conspiracy and nine counts of health care fraud.
- Charito Dela Torre, 71, a physician, was charged with one count of health care fraud conspiracy, 12 counts of health care fraud, and three counts of federal income tax evasion.
- Ricardo Gonzales, 75, a physician, was charged with one count of health care fraud conspiracy, 19 counts of health care fraud, and one count of violating the medical anti-kickback statute.
- Rosalie Gonzales, 42, a registered nurse and Ricardo Gonzales’ daughter, was charged with one count of violating the medical anti-kickback statute.
According to the indictment, Gabriel did not identify himself as an owner, but exercised ownership and control over Perpetual Home Health, Inc., and Legacy Home Healthcare Services.
Federal officials allege that 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. Between 2008 and January 2011, Legacy submitted more than 2,000 claims for Medicare reimbursement and received more than $6 million. Neither Perpetual nor Legacy had any sources of revenue other than Medicare funds, the indictment states.
The indictment adds that Gabriel conspired with the other defendants and obtained personal information of Medicare beneficiaries to bill Medicare without the beneficiaries’ knowledge or consent; paid bribes and kickbacks to physicians and others in exchange for referrals of patients to Perpetual and Legacy; created false patient files to support fraudulent Medicare claims and submitted false claims based on those records; used Medicare proceeds to pay themselves and others who assisted in carrying out the scheme; and concealed the fraud proceeds by directing Perpetual and Legacy to issue checks payable to fictitious entities, John Gabriel’s friends and associates.
If found guilty, Gabriel and the other defendants face 10 to 20 years in federal prison.
Subscribe to INQUIRER PLUS to get access to The Philippine Daily Inquirer & other 70+ titles, share up to 5 gadgets, listen to the news, download as early as 4am & share articles on social media. Call 896 6000.