Home Care Operator Accused Of Swindling Medicare Out Of $20M
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CHICAGO (CBS) — Federal authorities have charged a home health care business operator with bilking Medicare out of at least $20 million.
Jacinto “John” Gabriel Jr., 43, is charged with submitting millions of dollars in false claims to for reimbursement for services purportedly provided to Medicare beneficiaries.
The services in question were sometimes never provided, were sometimes medically unnecessary, and were sometimes inflated in price just to ensure that Gabriel could get back some Medicare funds to pocket, according to the U.S. Attorney’s office.
In total, Gabriel allegedly filed a total of more than 16,000 fraudulent Medicare claims. He took away more than $38 million in Medicare claims for one of his companies, Oak Forest-based Perpetual Home Health Inc., prosecutors said. He took home more than $5 million in Medicare claims from his other company, Legacy Home Healthcare Services, based on Chicago’s North Side.
Gabriel often billed Medicare without telling the patients, and made up false patient files to support Medicare claims, prosecutors said. He had his staff list false diagnoses of arthropathy – or joint disease – and hypertension, which allowed him to submit a larger claim to Medicare, prosecutors said.
Gabriel and the others in his scheme allegedly used their ill-gotten gains to fund lavish lifestyles, including gambling trips to Las Vegas and visits to Chicago area casinos, cars, jewelry, and real estate in the United States and the Philippines. Gabriel also gave paid his employees and bought them gifts, bribed doctors, and paid kickbacks for patient referrals using the money he swindled from Medicare, according to the U.S. Attorney’s office.
Gabriel allegedly tried to cover his tracks by having Perpetual and Legacy issue checks payable to made-up entities, as well as friends and associates, instead of himself.
He also cashed 11 checks under $10,000 to evade federal currency transaction reporting requirements, which led to a money laundering charge, prosecutors said.
Gabriel did not go to medical school, had no formal medical training, and had no license to practice as a health care professional, prosecutors said.
He stands charged with two counts of wire fraud, two counts of health care fraud, and 11 counts of money laundering in the 15-count indictment returned Tuesday, prosecutors said.
If convicted of all counts against him, Gabriel could receive a prison sentence of 280 years.