Medicare Fraud

CHICAGO – Filipina Nelia Laurel, owner of the Omega Homehealth Care Network, started serving her one-year sentence on Feb. 3, 2015 after she pleaded guilty to defrauding Medicare of nearly one million dollars.

Judge Robert M. Dow, Jr. of the U.S. District Court of the Northern District of Illinois in Chicago sentenced the 54-year-old businesswoman last Dec. 1 to a single count of felony offense for making or causing to be made false statements or representations involving the federal healthcare programs. Laurel had earlier been indicted with four counts of Medicare fraud (plus forfeiture) along with her business partner, Maristela Canete.

On April 3, 2013, Laurel entered into a plea agreement on superseding information, charging her with knowingly and willfully causing false representation of material fact to be made in an application for payment to the federal healthcare program, Medicare.

She caused Company A to submit to Medicare a payment claim that falsely represented that in October 2003 approximately 391 hours of continuous care services had been provided to Patient A by at least a registered nurse or a licensed practical nurse.

From September 2001 to October 2003, Omega provided purportedly licensed nursing staff to render continuous care services to Medicare patients at Company A’s home-based hospice program.

In January 2002, Laurel learned that Maristel Canete hired and directed unlicensed or improperly licensed individuals to provide services on behalf of Omega and allowed Canete to direct the unlicensed or improperly licensed individuals to provide services care for Company A’s home-based hospice program.

Laurel’s co-defendant’s Canete’s company, Angel Touch, billed $127 a day for routine care. But the payment billed by Omega for a continuous care of eight hours a day at $31.11 an hour had amounted to $280,000 of loss per month and for six months of continuous care a total of $933,333.

Laurel’s lawyer, Brooke L. Lewis, asked Judge Dow for leniency and prayed to the court to sentence Laurel to probation, saying Laurel guilty plea demonstrated acceptance of responsibility for her actions. Lewis said this has assisted authorities in the investigation and prosecution by timely notifying them of her intention to enter a plea of guilty.

Lewis added, “Laurel also accepted her wrongdoing in turning blind eye to the actions of her co-defendant Canete and allowing Canete to continue providing false information to Medicare thru Vitas. She is currently a participating and valuable member of the community and has learned from her mistake and this experience. A sentence of probation is sufficient, but not greater than necessary in this case.”

But U.S. Attorney Zachary T. Fardon’s assistant, Assistant U.S. Attorney Kruti Trivedi, opposed the prayer for probation, saying Laurel “lied over an extended period of time and caused others to lie over an extended period of time so that she and her company could benefit.”

Trivedi added, “The defendant is not an uneducated individual thrust into a position of responsibility who made one impetuous decision to steal. (She was) a relatively sophisticated businesswoman who owned and managed a sizeable business who was more than willing to engage in fraud in order to make more money.

“To sentence defendant to probation understates the seriousness of the offense, does not promote respect for the law to the same extent that a longer sentence does, and does not provide just punishment for the crime.”

Laurel was assessed a fine of $100 but she was not sentenced to a supervised release because she would be deported after serving her sentence of 12 months and one day. She is also ordered to turn over her Philippine passport to the custody of the U.S. government.

Judge Dow recommended that Laurel be committed to the Federal Prison Camp Alderson, a female minimum security prison facility located in Southern West Virginia or “an appropriate facility closest to Chicago.”

Laurel, a resident of Chicago’s suburban Glenview, Illinois and owner and operator of Omega Healthcare Network, both based in Glenview and suburban Evanston, Illinois, originally faced a maximum of 57 months (4.75 years) of imprisonment for the crime and a fine of $250,000 shortly after she signed a plea agreement.

Judge Dow set the trial for Canete on March 3, 2015.

Canete, a resident of Carpentersville, Illinois, was the owner and operator of Angels Touch Healthcare, located in Schaumburg, Illinois.

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Joseph is a former reporter of the Manila Bulletin, former president of the Rizal-Metro Manila Reporters Association and former president of the Chicago chapter of the National Press Club of the Philippines. A native of Sorsogon, Philippines, he and his family now live in Chicago. A prolific reporter, Lariosa writes a column and news stories for the Filipino Star News and other Filipino community newspapers in the US as well as for GMA News and the Manila Bulletin.

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