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From Texas to Chicago, Feds Cracks Down on Medical Abuse

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Federal agents continue their crackdown on Medicare abuse spanning from the Texas Border to Chicago, in a series of cases that have resulted in 243 individuals getting charged in the federal courts of 17 different districts.

Breitbart Texas initially reported this week on four criminal indictments accusing health care providers, home health care business owners, and employees and others of defrauding the federally funded Medicare and the Texas Medicaid programs.

Breitbart Texas then met with federal officials who confirmed that along the Texas border they had six indictments, including that included the four previously reported, as well as one in Laredo and one in Brownsville.  The cases were investigated by the FBI, the Office of Inspector General for the Department of Health and Human Services, and various state agencies nationwide.

The series of recently handed down indictments and ongoing arrests were all part of the national crackdown aimed at curbing Medicare fraud. Just as in South Texas prosecutors were able to get six indictments charging more than a dozen people, in Chicago prosecutors were able to charge 12 individuals in their cases.

“Health care fraud extracts a huge toll on our nation’s health care system,” said U.S. Attorney Zachary Fardon, in a prepared statement obtained by Breitbart Texas. “We will continue to aggressively pursue those health care providers that take advantage of not only the system but the patients they are entrusted to take care of.”

In one of the cases in Chicago, a superseding indictment accuses seven individuals with three separate but related home health care agencies in a $45 million fraud, information provided by the U.S. Attorney’s Office revealed.  The scheme that the individuals are accused of taking part in is tied to deals involving the use of kickbacks and bribes to get Medicare beneficiaries in order to bill the system for services that the patients didn’t need nor get.

The people charged in this case include Josephine Tinimbang, an owner and operator of the companies; Dr. Jose Calub, the medical director; Sharon Gulla, a registered nurse and a former supervisor; and Marilou Lozano, Ronald Malalis, Mary Pilar Mendoza, and Isabelita Sabejon, registered nurses who enrolled non-homebound beneficiaries and fabricated medical records. According to the U.S. Attorney’s Office, two defendants were charged in an earlier indictment: Sherwin Cubelo, a patient recruiter who received illegal kickbacks; and Janet Guerrero, an office manager who administered the kickbacks.

In another case, FBI agents investigated 70-year-old Barry Fischer, who was later charged in a 20-count indictment accusing him of billing Medicare for visits that were not needed, and doctoring documents in order to certify patients received home health care from the companies that Fischer worked for, the information provided to Breitbart Texas by federal authorities revealed.

In yet another case, authorities charged 78-year-old Zenaida Dimailig, who allegedly paid cash kickbacks to Medicare-covered patients,  who then gave her their Medicare information so she could bill Medicare for home-health services that these individuals did not need, using a home health care agency to charge the government for the services.

In another of the cases FBI agents went after 46-year-old Omeed Memar, a Chicago dermatologist who ended up getting charged in a 16-count indictment for billing cosmetics treatments as the treatment of pre-cancerous lesions in order to have private and public insurers pay for the treatments, authorities said.

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