Lincolnwood Business Indicted for Medicare Fraud

A Des Plaines woman has been indicted for her reported role in what federal prosecutors described was a conspiracy involving kickbacks for Medicare patients, the U.S. Attorney’s Office announced on Monday.

Rakeshkumar Shah, 46, of Des Plaines, four others, and a home healthcare agency in Lincolnwood were named in the suit.

Marilyn Maravilla, 55, of Chicago, Junjee L. Arroyo, 44, of Elmhurst, Ferdinand Echavia, 39, of Chicago, and Jean Holloway, 41, of Bellwood, and Shah are accused of paying and receiving approximately $400,000 in kickbacks to themselves, nurses, marketers and others to refer and retain Medicare patients that allowed the Lincolnwood business named in the complaint, Goodwill Home Healthcare, to bill Medicare approximately $5 million between August 2008 and July 2010, according to the press release.

The Medicare Fraud Strike Force expanded operations to Chicago in February 2011 and is part of the Health Care Fraud Prevention and Enforcement Team, a joint initiative by the Justice Department and the U.S. Department of Health and Human Services, according to the press release.

Lamont Pugh III, special agent in charge of the Chicago Region of the U.S. Department of Health and Human Services, stated in the announcement, paying kickbacks to refer Medicare patients was illegal.

“Money cannot be permitted to be the basis of a medical referral over medical necessity or quality of service,” Pugh stated.

Earlier:

The complaint states Maravilla and Arroyo, both part owners of Goodwill Home Healthcare, sent a memo to employees in January 2009 that outlined a payment structure illegal payments as disguised bonuses. A $100 bonus would be given to nurses who re-certified a patient for a third, 60-day cycle, and a $200 bonus would be paid to nurses who re-admitted a discharged patient a month after the discharge date. Kickbacks to nurses, marketers and the company owners ranged from approximately $400 to $700 for new care cycles and $100 to $300 for re-certifications.

Maravilla and Arroyo are accused of causing Goodwill to pay $21,500 in kickbacks to Shah and $10,400 to Holloway, according to court documents.

All six defendants were charged with one count of conspiracy to pay and receive illegal kickbacks for Medicare patient referrals, and each defendant was also charged with the following number of counts of violating the anti-kickback statute: Goodwill, 16 counts; Maravilla, 15 counts; Arroyo, 16 counts; Echavia, five counts; Holloway, three counts; and Shah, eight counts, according to the press release.

Conspiracy and each count of violating the anti-kickback statute carry a maximum penalty of five years in prison and a $250,000 fine.

Shah and Holloway pleaded not guilty in U.S. District Court and were released on bond.

Maravilla, Arroyo, Echavia, the licensed nurses and Goodwill Home Healthcare are scheduled to be arraigned in U.S. District Court on Aug. 22.

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