7 indicted in NW suburban Medicare fraud scheme

SHARE 7 indicted in NW suburban Medicare fraud scheme
SHARE 7 indicted in NW suburban Medicare fraud scheme

A northwest suburban couple who own a home-healthcare business paid kickbacks to employees and marketers in exchange for referring elderly and disabled patients for unnecessary treatment that was funded by Medicare, according to a 23-count indictment unsealed Thursday.

Estrellita and Miguel Duquilla, ages 58 and 60, own HCN Home Healthcare Inc., 6288 N. Cicero Ave., and were charged with conspiracy to pay and receive healthcare kickbacks, according to a statement from the U.S. Attorney’s office.

The Des Plaines residents face a litany of other federal charges including paying kickbacks and Medicare fraud for the alleged scheme, which resulted in more than $6 million of fraudulent payments to HCN from 2008 to 2012, prosecutors allege.

Federal investigators searched the company’s office and found many beneficiaries weren’t qualified for home-health services, and in several instances never needed or received the care, prosecutors said.

Also charged in the conspiracy were four of the company’s employees and an outside marketer who is married to an HCN nurse, according to the statement. The indictment stated that the HCN employees altered nursing reports and patient files to make it appear that a patient qualified for in-home treatment, according to the statement.

Prosecutors say 78-year-old Bensenville resident Zenaida Dimaili; 59-year-old Des Plaines resident Grace Mendez; and 49-year-old Chicago resident Sherrod Harris were nurses for the company who changed patients’ reports to make it appear they qualified for home treatment.

Dimaili’s 58-year-old husband Roberto Jonson received payments as an outside marketer in exchange for referring non-homebound Medicare beneficiaries to HCN, according to the indictment.

They each face various conspiracy and Medicare fraud charges, which could carry amaximum penalty of ten years in prison and a $250,000 fine.

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