CHICAGO (CN) – A federal grand jury accused a man of submitting $1 million in fraudulent Medicare claims: claiming that his now-unlicensed doctor employee saw elderly patients more than 24 hours a day.
Bryan Day, 42, “was not a licensed medical provider,” but operated and was part-owner of Charm Development in Chicago Heights, which “purported to offer psychotherapy services to patients, primarily in nursing homes and long-term care facilities,” according to the indictment.
“Day submitted and caused to be submitted fraudulent claims to Medicare for individual psychotherapy services purportedly performed by Doctor A. In fact, as the defendant was aware, such services were not rendered by Doctor A. In addition, the claims included services that were purportedly provided at times when Doctor A was not present at Charm, and not licensed by the State of Illinois,” the indictment states.
Day “paid Doctor A approximately $3,000 a month to use his Medicare provider number and to act as on-site physician at Charm,” according to the indictment.
It adds: “Day submitted and caused to be submitted claims to Medicare for individual psychotherapy purportedly rendered by Doctor A in excess of 24 hours per day.”
Day submitted claims to Medicare for $1,079,000, of which Medicare paid $439,000, according to the indictment.
It adds: “Doctor A was a doctor licensed to practice medicine in the State of Illinois until July 31, 2008, after which he was no longer licensed. Doctor A was employed at Charm from on or about May 12, 2005, until he resigned from Charm on or about February 10, 2009.”
If convicted Day faces up to 10 years in prison on each of six counts of health care fraud.
The Justice Department called this indictment “part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that led to charges against 108 individuals for their alleged participation in schemes to collectively submit more than $455 million in fraudulent claims to Medicare. This takedown involved the highest amount of false Medicare billings in a single takedown in Strike Force history.”