Local Biz Owners Caught In $4 Million Healthcare Scam

Three health clinic co-owners are among seven defendants charged with engaging in five separate, unrelated health care fraud schemes to defraud the Medicare program or private health insurers of millions of dollars, federal law enforcement officials announced today.

Ankur Roy, Akash Patel and Dipen Desai, who owned and operated Selectcare Health, Inc., which provided outpatient physical and respiratory therapy in Park Ridge and Skokie, were charged with submitting more than $4 million in false billings to Medicare between March and July 2011, according to authorities. 

Between March and July 2011, the defendants allegedly submitted $4,009,094 in false billings for services that were purportedly provided between April 2010 and April 2011, resulting in payments totaling approximately $2,214,424 from Medicare and $320,881 from Blue Cross Blue Shield, according to the indictment.  The claim seeks forfeiture of $2,535,305 in alleged fraud proceeds, including $446,974 in funds withdrawn by cashiers’ checks that were seized by the FBI in July 2012.

Each defendant was charged with six counts of healthcare fraud in an indictment that was returned by a federal grand jury last Wednesday and unsealed today.   

Roy, 36, of Miami was arrested today in Florida, while Patel, 33, of Morton Grove, and Desai, 33, of Chicago, will be ordered to appear for arraignment on a later date in U.S. District Court in Chicago.

According to the indictment, the defendants submitted false claims to Medicare and Blue Cross Blue Shield on behalf of Selectcare patients for respiratory therapy services that were never provided. 

The alleged false billings sought reimbursement for services purportedly provided on days that Selectcare’s sole respiratory therapist was not working; for time periods in which the patients were not receiving care from Selectcare; and for treatment seven days a week for three hours per day, a schedule well in excess of any schedule prescribed for patients at Selectcare.

Roy, Patel and Desai used a third-party billing service to forward the alleged false claims to Medicare, as well as to private insurers such as Blue Cross if the patient had supplemental private insurance, including insurance funded by labor union health and welfare plans, authorities said.

--

Patch on Facebook