Feds Sue Flossmoor Husband, Wife For Millions From False Medicare Billing

CHICAGO, IL — A Flossmoor husband and wife are accused of using the health care company they owned to wrongly collect millions of dollars from falsely billing Medicare for fraudulent services, according to a federal civil lawsuit filed Tuesday. Ajibola Ayeni and Joy H. Turner-Ayeni, owners of Gateway Health Systems Inc., allegedlly sought and received Medicare payments for care to homebound patients that was either unnecessary or did not exist, a violation of the federal False Claims Act, the U.S. Attorney's office said in a statement Tuesday. The lawsuit also implicates Docs at the Door P.C., a home-visiting doctor business owned by Ayeni, in the scheme, the statement added.

According to the lawsuit, the couple allegedly had both companies falsify paperwork to hide the fraudulent services Medicare patients were receiving. As part of the scheme, Docs at the Door would fraudulent certify that non-homebound patients needed in-home care, and then home doctor visits would be falsely charged at the second-highest billing in order to collect more from Medicare, the U.S. Attorney's office said.

Once the couple was under investigation, they allegedly tried to hide the ownership of certain properties in order to avoid paying a judgment if fraud was proven or because they had racked up debts they couldn't pay, the lawsuit states. The couple transferred a home in Flossmoor, two apartments in Chicago and two properties in Frankfort into trusts in 2016, and the lawsuit asks for those transfers to be voided because they constitute fraud. (Get Patch real-time email alerts for the latest Homewood-Flossmoor news. And iPhone users: Check out Patch's new app.)

The federal complaint filed Tuesday is the result of the government intervening in a private individual's 2013 lawsuit filed under seal as part of the False Claims Act whistleblower provision. Under the act, individuals can sue for false claims on behalf of the government, and the government can step in to take over the lawsuit. For each false claim by the defendants, the government can recover three times the damages, plus civil penalties between $5,500 to $11,000, and the person filing the original lawsuit can share in the recovery.

Along with with the civil lawsuit, Ayeni faces an 11-count criminal indictment from earlier this year that alleges he committed health care fraud between 2011 and 2015 as the owner of Docs at the Door, the U.S. Attorney's office said. He pleaded not guilty to the federal charges, but his trial date has not been set.

Photo via Shutterstock

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