(STMW) — A north suburban man, partial owner of a hospice company, has been charged with health care fraud for improperly classifying patients into more lucrative care, according to federal prosecutors.
Seth Gillman, 46, of Lincolnwood was charged Friday with one count each of health care fraud and obstructing a federal audit, a statement from the U.S. Attorney’s office said.
Prosecutors say that between August 2008 and January 2012, Gillman trained nurses from Passages Hospice LLC, which he partially owned, to look for signs that a hospice patient could qualify for “general inpatient care,” which yields higher payments per day than routine care, federal prosecutors said in the statement.
Gillman, an attorney, knew that several patients were incorrectly being placed on GIP, some without a doctor’s approval, prosecutors allege.
In one example, west suburban Lisle-based Passages billed Medicare for 1,443 days of hospice care, but the patient’s son told investigators his mother was in no danger of dying until the last month of her life, the statement said.
Of 13 Passages patients, a government expert found nine patients’ billed days for GIP were “improper and excessive,” prosecutors said.
Gillman took $833,375 in bonuses for himself between March 2009 and prosecutors said. He also made bonus payments to Passages’ directors.
Prosecutors also allege the company gave $250 per patient to eight nursing homes in 2010 to place them on GIP.
Gillman was to have his initial court appearance at 3 p.m. Monday before Magistrate Judge Geraldine Soat Brown at the Dirksen Federal. If convicted of both charges, he faces up to 15 years in prison and fines of up to $500,000.
(Source: Sun-Times Media Wire © Chicago Sun-Times 2014. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)