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Coalition Against Insurance Fraud

lllinois doc charged with doing unneeded in-home med tests

December 11, 2018, Chicago, IL — A federal grand jury in Chicago has indicted a physician on fraud charges, according to the U.S. Attorney's Office for the Northern District of Illinois. The doctor approved medically unnecessary diagnostic tests that were billed to Medicare, the indictment alleges.

While working for Chicago-based Grand Medical Clinic Inc. in the city's West Town neighborhood, Dr. Omar Garcia prescribed and authorized ultrasounds, percutaneous allergen tests and nerve transmission tests for numerous Medicare beneficiaries, knowing that the in-home tests were not medically necessary, the attorney's office said.

In some instances, Garcia approved the tests after they had already been completed, the indictment states. Garcia and others submitted or caused to be submitted fraudulent claims to Medicare for payment of the unnecessary tests, according to the indictment.

The indictment alleges that Garcia's fraud scheme began in 2011 and continued until 2015. Dr. Garcia and others submitted the fraudulent bills from multiple medical entities in an attempt to reduce the volume of billing by any single company and minimize scrutiny from Medicare, the indictment states. After the entities received payments from Medicare, Dr. Garcia was paid via checks reflecting his percentage of the payments, the indictment alleges.

The indictment was returned Thursday in U.S. District Court in Chicago. It charges Garcia, 51, of Ocala, Fla., and formerly of Illinois, with six counts of health care fraud.

Garcia's arraignment has not yet been scheduled.

Source: Patch

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