Bloomingdale doctor gets two years for Medicare fraud

A northwest suburban doctor has been sentenced to two years in federal prison for a fraud scheme that cost the Medicare program at least $4 million.

Dr. Arthur Davida, 62, who was an employee and part-owner of Bloomingdale-based Home Care Physicians Inc., pleaded guilty last year to health care fraud, according to a statement from the U.S. attorney’s office.

U.S. District Judge John Tharp Jr. imposed the 24-month sentence, saying the crime is a “very serious offense” that involved “stealing money” from Medicare.

Davida, of Bloomingdale, received referrals from home-health agencies in exchange for providing certification that patients were confined to home, prosecutors said. The agencies would then bill Medicare for specialized nursing care for in-home treatment.

Between 2010 and August 2013, the doctor provided certification even though at least 20 percent of the patients were not confined to their homes, and Medicare was thus billed for treatments Davida knew were not medically necessary, prosecutors said.

In a plea agreement, Davida acknowledged that he feared that if he didn’t provide the certifications, the agencies would stop sending him referrals, prosecutors said.

Medicare paid the agencies more than $20 million based on orders signed by Davida. Because 20 percent of those patients were not confined to the home, the agency lost at least $4 million, prosecutors said.

The Medicare Fraud Strike Force, which consists of agents from the FBI and HHS, conducted the investigation with prosecutors from the U.S. attorney’s office and the Justice Department’s Fraud Section.