Four Chicago Nursing Facilities Caught Up in Medicare Fraud Whistleblower Case
Some Chicago nursing homes and rehabilitation centers are paying nearly $10 million back to the U.S. government after being caught lying about the level of care their patients required and for violating the False Claims Act by overbilling federal health insurers. Greed came through by abusing power over resident benefits paid for through Medicare and maximizing those amounts under fraudulent therapies and support.
At the center of the fraud sat Quality Therapy and Consultation Inc. of Orland Park, and its owner, Frances Parise. Parise allegedly worked with these four Chicago facilities.
- Lakeshore Healthcare in Rogers Park (settled for $2.7 million)
- Balmoral Home at 2055 W. Balmoral Ave. (settled for $1.7 million)
- Ridgeview Rehab, of Rogers Park (settled for $1 million)
- Carlton at the Lake, Inc., at 725 W. Montrose Ave. (settled for $3.6 million)
In addition to these large settlements, Parise will pay $160,000 and be excluded from federal health programs for five years, the U.S. Attorney’s Office for the Northern District of Illinois said in a statement.
Scheme Uncovered by Whistleblower
These settlements closed a 2014 case that began as a federal whistleblower lawsuit. The whistleblower, Katherine Verhulst, worked as an occupational therapist with Quality Therapy and Consultation at the time of the fraud. She will receive a $1.9 million cut of the recovered money.
Whistleblowers have legal protection from retaliation for reporting or threatening to report violations of the laws or regulations concerning nursing home residents and administrators. This means that if you are a nursing home employee who becomes a whistleblower, it is illegal for an employer to fire you, reprimand you, suspend you, demote you, refuse to promote you, deny a transfer, or change your employment terms or conditions based on the fact that you filed a complaint.
Medicare Fraud Unjustly Enriches the Perpetrators
Healthcare fraud is entirely unacceptable in all its forms but seems to be occurring more often each year at unfathomable amounts. In April of 2019, a 12-person jury deliberated for four days before finding Philip Esformes, a 50-year-old entrepreneur and owner of a network of 16 nursing homes and assisted living facilities in Florida, guilty on 20 out of 26 charges related to healthcare fraud.
To date, this is believed to be the largest fraud scheme ever charged by the U.S. Justice Department and a reflection of greed through receiving kickbacks, money laundering and conspiracy to commit federal program bribery totaling $37 million.
Anyone involved with nursing homes should be aware of these illegal acts, their implications for patients and residents, and the importance of protecting patients from the money hungry overzealous actions of administrators, clinicians, third party care providers, and large nursing home chains.
Concerned about Medicare and Medicaid Fraud in Illinois?
For the last decade, Attorneys General have been partnering with private law firms to sue large nursing home chains for negligent care related to Medicare and Medicaid fraud. If you believe that your family may be affected by healthcare fraud in any form in the State of Illinois or if your employer is taking part in a Medicare and Medicaid fraud scheme, you should take action quickly and contact our lawyers online or call us at 877-374-1417 or 312-332-2872 to set up a FREE consultation.
Also read: Genesis Healthcare Owes $54 Million to Whistleblowers Who Exposed Hospice Fraud