Home Health Owners, Nurses Charged in $6 Million Fraud Case

A husband and wife in charge of a Chicago-based home health care business and nurses employed by the company are among those who have been accused in a more than $6 million fraud scheme, according to a federal indictment unsealed late last week.

Estrellita and Miguel Duquilla, the owners of HCN Home Healthcare Inc., were charged with bribing employees and marketers to refer Medicare beneficiaries to the company and having employees change nursing reports and patient files to falsely reflect beneficiaries’ need for in-home treatment from 2008 to 2012, according to the U.S. Attorney’s Office of the Northern District of Illinois. In doing so, the indictment claims Medicare overpaid HCN by more than $6 million.

The Duquillas, of Des Plaines, were each charged with conspiracy to pay and receive healthcare kickbacks, one count of conspiracy to commit health care fraud and 10 counts of Medicare fraud. Also charged in the scheme were four HCN employees and an outside marketers.

Many of the elderly and disabled referred to HCN were ineligible for home health services, according to the indictment, and in many cases didn’t need or receive the care. The indictment states that in still other cases, employees and marketers paid cash to patients in exchange for permission to use their information for paperwork submitted to Medicare.

Estrellita Duquilla, 58, was additionally charged with five counts of paying kickbacks to induce referrals of Medicare beneficiaries. Miguel Duquilla, 60, was charged with two counts of the same crime. In total, four nurses were charged with various counts of kickback conspiracy, Medicare and health care fraud and soliciting health care and Medicare kickbacks.

Representatives with HCN could not be reached Monday for comment regarding the allegations.

The indictment comes amid a federal investigation, which included the execution of a search warrant at the HCN office. Federal officials say the investigation is ongoing.

The Medicare fraud and health care fraud conspiracy counts carry a maximum 10-year prison sentence and a $250,000 fine. The kickback and kickback conspiracy charges are punishable by up to five years in prison and a $250,000 fine.

Written by Kourtney Liepelt