Feds Nab 400 Medical Pros in Largest Health Care Fraud Take-Down in U.S. History

CHICAGO — Several Chicago-area medical professionals, including two licensed physicians, are facing federal criminal charges as part of the largest health care fraud enforcement action in Department of Justice history, federal authorities announced Thursday.

The national enforcement action taken by the Medicare Fraud Strike Force involved more than 400 defendants charged in 41 federal districts across the country, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings.

More than 20 state Medicaid Fraud Control Units participated in Thursday's arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to 295 providers, including doctors, nurses and pharmacists.

Thursday's enforcement actions were led and coordinated by the Criminal Division Fraud Section’s Health Care Fraud Unit, in conjunction with its Medicare Fraud Strike Force partners – a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. The operation also includes the DEA, DCIS, and State Medicaid Fraud Control Units.

“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” U.S. Attorney General Jeff Sessions said. “While today is a historic day, the Department's work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”

Several Chicago-area medical professionals, including two doctors, were charged as part of investigations in the Northern District of Illinois, according to a news release.

“Health care fraud is a serious crime that can have devastating consequences,” said Acting U.S. Attorney Joel R. Levin. "Our office will continue to vigorously investigate and prosecute those who seek to enrich themselves through fraudulent health care schemes.”

FBI Chicago Special Agent-in-Charge Michael Anderson said the arrested individuals represent, "Once trusted doctors, nurses, and other medical professionals who were corrupted by greed and preyed on the vulnerable; utilizing them to bill for services or drugs that were unnecessary or never provided."

One of the Illinois cases involved Beatta Kabbani, a licensed physical therapist who was charged in a 13-count indictment with health care fraud and aggravated identity theft. Kabbani is the owner of MedCare Medical Group in Glenview. The indictment charges Kabbani with submitting more than $2 million in false claims to Blue Cross Blue Shield of Illinois and United Health Care. Charges state that Kabbani used a physician’s National Provider Identification number to substantiate some of those false claims. She is scheduled to be arraigned on July 26.

Another Illinois case involved Jeffrey Witek and Stephen Hoesley, licensed chiropractors charged in an 18-count indictment with health care fraud. The charges stem from their alleged participation in a scheme to defraud Blue Cross Blue Shield of Illinois. Witek and Hoesley submitted at least $1.1 million in fraudulent claims to Blue Cross Blue Shield of Illinois that falsely represented that certain health care services were provided to patients, knowing that those services were not actually provided. They are both scheduled to be arraigned on Aug. 2.

Zosima Victuelles, Mylene Masiclat, Maribel Cabrera, Yaseen Odeh and Mohammad Raza Khan are also Illinois practitioners. They were charged in a 28-count indictment with conspiracy to offer and pay, and to solicit and receive, kickbacks and bribes for the referral of Medicare beneficiaries to Sure Care Home Health Corp.

The indictment also charges substantive violations of the anti-kickback statute. Victuelles, Masiclat and Cabrera were the owners of Sure Care, a home health agency with offices in Glendale Heights and Rockford. Victuelles and Cabrera are also licensed nurses, while Odeh and Khan are licensed medical doctors. Charges stem from Victuelles, Masiclat, Cabrera and others paying Odeh, Khan and others more than $435,000 in kickbacks and bribes for the referral of Medicare beneficiaries to Sure Care. Arraignments in federal court in Chicago had not yet been scheduled Thursday.

The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The team operates in nine locations nationwide. Since its inception in March 2007, it has charged more than 3,500 defendants who collectively have falsely billed the Medicare program for more than $12.5 billion.