Detroit Patient Recruiter Sentenced to 30 Months

Last week, Santiago Villa-Restrepo, who plead guilty to conspiracy to commit health care fraud in November 2011, was sentenced to 30 months in Prison and has been ordered to repay nearly $3 million, with the assistance of his co-defendants.

Villa-Restrepo plead guilty to providing kickbacks to Medicare recipients who took part in medical tests at several Detroit based medical clinics. Medicare recipients allegedly signed forms stating they had undertaken treatment from these clinics and, in return, received case from Villa-Restrepo and his co-defendants.

The owners of these clinics are also charged, were allegedly complicit in this crime, which resulted in around five and a half million dollars in Medicare fraud. While Villa-Restrepo was not convicted until November 2011, the Medicare fraud dated back to 2007.

Villa-Restrepo faced up to 10 years in prison when he was originally convicted.

Five Plead Guilty in Michigan Medicare Scam

Last week, Maira Suleman and three other individuals plead guilty to a single count of conspiracy to commit health care fraud, as the result of their part in an alleged Medicare Fraud Scheme related to two home medical companies. Another man, Gerald Funderburg, also plead guilty in an unrelated Medicare Fraud case.

Suleman, Curtis Mallory, Theodore Haile, and John Thomas are scheduled to be sentenced on April 19, 2012 and each face up to ten years in prison and up to a quarter of a million in fines.

According to the plea agreement, the defendants Mallory, Suleman, and Haile were complicit in Medicare Fraud at All American Home Care Inc. and Patient Choice Home Care Inc.

All American Home Care and Patient Choice Home Care were incorporated, according to Michigan’s business database, in 2005 and 2007 respectively. They are involved with home health care.

As part of the plea agreement, Mallory and Haile stated they paid kickback to Medicare recipients, as part of their jobs as patient recruiters for these companies. In turn, the Medicare recipients information was used to submit fraudulent claims to Medicare for physical therapy that was either not preformed or was not medically required.

John Thomas admitted to creating false physical therapy documentation as part of his job as a physical therapist for both companies. This documentation was used to bill Medicare.

Maira Suleman is listed in the Articles of Incorporation for Patient Choice Home Care Inc. and stated in court that she was the office manager at this company. Another man, Hassan Akhtar, has ties to both companies, according to public business records.

Suleman admitted to helping facilitate the Medicare fraud by coordinating the collection and documentation of fabricated therapy forms, as well as preforming the actual submission of claims to Medicare for payment.

In the separate case, Gerald Funderburg admitted responsibility for illegally using information from around 500 different Medicare recipients, without their knowledge, in order to submit claims for mental health services that were not preformed in most cases.

Funderburg is listed as the sole owner of Funderburg Clinical and Community Services Inc( FCCS,) which was incorporated in 2006.

According to his plea agreement, admitted to submitting close to 5,000 fraudulent claims that were related to over $3 million billed to Medicare.

Funderburg is scheduled to be sentenced on June 8, 2012 and also faces up to ten years in prison and a $250,000 fine.