Telemarketer Involved in Home Health Scheme Convicted
Owner of telemarketing company Serenity Marketing, Inc., which previously did business as Serenity Living, Sundae Williams, was convicted of taking illegal kickbacks in exchange for referring patients to home health care agencies.
Williams, 47, of South Holland, Illinois, was charged in Chicago on Tuesday by a federal jury with one count of conspiracy to solicit and receive remuneration in return for the referral of Medicare patients, and six counts of soliciting and receiving remuneration in return for the referral of Medicare patients. Each count could bring up to five years behind bars.
The kickbacks were accepted by Williams after he used unsolicited phone calls to recruit patients, including Medicare beneficiaries, for home health services. Williams then referred those patients to numerous nursing agencies in the Chicago-area in exchange for payments on a per-patient basis.
Evidence showed that Serenity employees were trained to cold-call Medicare beneficiaries and convince them to accept home health services and if someone expressed interest, Serenity employees obtained their personal information, including his or her Medicare number. Then, Serenity provided it to certain home health agencies that agreed to pay the company for such referrals.
Earlier this year, convictions were given to three other individuals who played a role in the scheme. James Ademiju, a nurse who operated two suburban nursing agencies, pleaded guilty to billing for unnecessary services and making illegal payments for patient referrals. Ademiju also testified at Williams’ trial that some of his payments were illegally made to Serenity. He also admitted that he sent some of the patients he had obtained illegally from Serenity to Suburban Home Physicians and other home-physician companies. Ademiju said he did this because he thought that physicians at those companies would order home health services even if the patients didn’t qualify for them.
Dr. Alan Newman, a doctor at Suburban Home Physicians, which did business as Doctor at Home, pleaded guilty to falsely certifying patients for nursing services even when he was fully aware the patients didn’t qualify or the care. He admitted causing Medicare approximately $2.6 million. Both Newman and Ademiju are awaiting sentencing.
The fourth individual involved in the scheme, Diana Jocelyn Gumila, a nurse and manager of Suburban Home Physicians, was convicted of directing employees to provide in-home services to patients she knew didn’t need them. She directed employees to certify patients for home-health services even when they didn’t qualify for it. In addition, Gumila directed her employees to bill treatments at the most complicated levels, even though they were typically routine treatments. This way of billing inflated the costs incurred by Medicare. Gumila was sentenced last month to six years in prison.
The entire investigation is being carried out by a joint initiative between the U.S. Justice Department and The U.S. Department of Health and Human Services, the Medicare Fraud Strike Force, which is part of the Health Care Fraud Prevention & Enforcement Action Team. The organization, which began operating in Chicago in 2011, was established to prevent fraud and enforce anti-fraud laws around the country.
Written by Alana Stramowski