Six Pinoy health workers indicted over $20-million Medicare scam in US

The United States Department of Justice indicted six Filipino health workers in a $20-million swindling case filed against another Filipino immigrant, the news site Asian Journal said. In a report on April 25, the Asian Journal said the United States Attorney for the Northern District of Illinois Patrick Fitzgerald named two Filipino physicians and four Filipino registered nurses among the 11 new defendants to a case involving a $20-million Medicare scam. Citing a report of the Federal Bureau of Investigation in March, the Asian Journal said the 11 persons were named as additional defendants in a case against Jacinto “John” Gabriel Jr., who allegedly defrauded the state-run Medicare of some $20 million by submitting false medical claims. The six Filipinos among the 11 new defendants were identified as: Jassy Gabriel, 42, registered nurse and brother of John Gabriel Jr. Stella Lubaton, 46, registered nurse Nessli Reyes, 35, registered nurse Charito Dela Torre, 71, physician Ricardo Gonzales, 75, physician Rosalie Gonzales, 42, registered nurse and Ricardo Gonzales’ daughter All six, were charged with several counts of health care fraud conspiracy, health care fraud, federal income tax evasion, and violation of the medical anti-kickback stature. They were primarily accused of conspiring with Gabriel Jr., 44, of Berwyn, Illinois, who has also been charged with one count of health care fraud conspiracy, 43 counts of health care fraud, 11 counts of money laundering, and four counts of federal income tax evasion in March. Cold-calling beneficiaries Gabriel Jr.’s two home health care services, the Perpetual Home Health, Inc. and Legacy Home Healthcare Services, were found to have submitted false claims to Medicare for reimbursement for home health care services that were allegedly never provided or were not medically necessary. Perpetual reportedly submitted more than 14,000 Medicare claims between May 2006 and January 2011, and received more than $38 million in reimbursement. Legacy allegedly submitted more than 2,000 claims between December 2008 and January 2011 and received more than $6 million. Both companies have since ceased operations. Nine of the 11 new defendants, including all six Filipinos, allegedly aided Gabriel Jr. in several dubious schemes to secure payment for fraudulent reimbursement claims by: illegally obtaining personal information of Medicare beneficiaries, paying bribes and kickbacks to doctors for patient referrals to Perpetual and Legacy, and creating fake patient files to support Medicare claims. Gabriel and the others also allegedly took to cold-calling Medicare beneficiaries to persuade them to enroll for Perpetual and Legacy services. Furthermore, the money laundering charges alleged that Gabriel cashed in 11 checks from October to December 2009 in amounts under $10,000 to avoid federal currency transaction reporting requirements. Free on bond The indictment alleged that Gabriel Jr. and the others used the swindled funds to gamble in casinos in the Chicago and Las Vegas, perpetuate the business by providing their employees with gifts, and buy jewelry, cars, and real estate properties in the US and the Philippines. Gabriel Jr. had been previously arrested on preliminary charges in February of 2011, and was subsequently charged in a 15-count indictment. He pleaded not guilty and is currently free on bond. According to the Federal Bureau of Investigation, each count of health care fraud conspiracy and health care fraud carries a maximum penalty of a 10-year prison term $250,000 in fines, or an alternate fine totaling twice the loss or twice the gain, whichever is greater, and mandatory restitution. Each count of money laundering, meanwhile, carries a maximum 20-year prison term and a maximum fine of $500,000. A count of tax evasion carries a maximum five-year prison term, and each account of falsifying income tax returns carries a maximum three-year prison term. Moreover, defendants guilty of tax offenses are required by law to pay the costs of prosecution and a potential civil fraud penalty of 75 percent of the underpayment plus interest. - with Rouchelle Dinglasan, Ralph Angelo Ty/VVP, GMA News

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