The Medicare Fraud Strike Force (Strike Force) operating in conjunction with the U.S. attorney’s office for the Northern District of Illinois recently indicted the owner and a contractor of Hexagram Home Health Care LLC (Hexagram) based in Harwood Heights. Jacqueline Tuanqui, the owner of Hexagram, was charged with one count of criminal healthcare conspiracy and eight substantive counts of paying illegal kickbacks. In addition, Susie Avellanosa, owner of Allied Care Services Inc. of Elgin, was correspondingly charged with one count of criminal healthcare conspiracy and eight substantive counts of receiving illegal kickbacks.
The two women are alleged to have entered several written contracts, the purpose of which were to obscure the precise nature of their relationship. Specifically, the Strike Force has alleged that the Tuanqui agreed to pay a set monthly fee to Avellanosa in exchange for a pre-established number of referrals of elderly patients to Hexagram. The written agreements described the monthly payment as reimbursement for a set number of hours worked by Avellanosa, but the Indictment alleges that the actual purpose of the payment was for referrals. The women are further accused of seeking out and billing for services to non-homebound elderly patients in violation of Medicare requirements for home health services. Both have plead non-guilty.
The indictment marks at least the fifth case indicted by the Chicago Strike Force in 2015, evidence of a continued increase of activity by the Strike Force. As the Strike Force continues to expand, it can be expected that healthcare fraud enforcement in the Chicago area will continue to become more aggressive, as new targets are identified. Though there has been variety in the cases brought, the Hexagram case continues a theme in enforcement by the Strike Force in the home health industry around Chicago. It is particularly noteworthy that the defendants in the Hexagram case had a written agreement with one another, as a written agreement is often seen as the best defense against a kickback allegation. In this case, the government is not convinced that the services described in the written agreements accurately reflected the services provided under the arrangement.