Crime & Safety

Elmhurst Resident Indicted in Medicare Kickback Scheme

Home healthcare agency owner Junjee Arroyo of Elmhurst faces a total of 17 counts: one for conspiracy and 16 for anti-kickback statute violations. Each carries a penalty of five years and $250,000.

Editor's note: The following information was released Monday, Aug. 13, by the U.S. Attorney's Office for the Northern District of Illinois.

An Elmhurst resident who is co-owner of a home healthcare agency was indicted on federal charges for allegedly participating in a conspiracy to pay and receive kickbacks in exchange for referral of Medicare patients for home health services.

Elmhurst resident Junjee L. Arroyo, 44, along with Goodwill Home Healthcare co-owner Marilyn Maravilla, 55, of Chicago, and three other defendants allegedly conspired to pay and receive about $400,000 in kickbcks to themselves, nurses, marketers and others. This enabled Goodwill, which is based in Lincolnwood, to bill Medicare about $5 million.

Also indicted were Ferdinand Echavia, 39, of Chicago, a licensed nurse who referred patients to Goodwill, and Jean Holloway, 41, of Bellwood and Rakeshkumar Shah, 46, of Des Plaines, both of whom marketed Goodwill’s services to Medicare patients.
       
The 29-count indictment was returned by a federal grand jury Aug. 9 following the arrests of Holloway and Shah, who were released on bond after pleading not guilty.
       
Maravilla, Arroyo and Echavia, all licensed nurses, and Goodwill as a corporate defendant, are scheduled to be arraigned on Aug. 22 in U.S. District Court.
       
All six defendants were charged with one count of conspiracy to pay and receive illegal kickbacks for Medicare patient referrals. In addition, defendants also were charged with the following number of counts of violating the anti-kickback statute: Goodwill, 16 counts; Maravilla, 15 counts; Arroyo, 16 counts; Echavia, five counts; Holloway, three counts; and Shah, eight counts.
       
Maravilla began working as a nurse at Goodwill in August 2008 and became an owner and the administrator of the agency within two months. In addition to being co-owner, Arroyo was Goodwill’s director of nursing.
               
Between August 2008 and July 2010, the indictment alleges that Maravilla, Arroyo and two other individuals— an officer and an owner of Goodwill and a certified public accountant and Goodwill’s bookkeeper—paid and caused Goodwill to pay kickbacks to nurses, marketers and other home health care workers who referred patients to Goodwill; assisted in re-certifying patients as homebound; or caused patients to begin new 60-day care cycles of home health care with Goodwill. 

By offering kickbacks, Maravilla, Arroyo and others sought to increase Goodwill’s patient census and to enrich themselves and Goodwill. During this time, Goodwill obtained referrals of about 900 cycles of home health care, including new patients and the re-certification of existing patients for additional 60-day cycles of care.
       
According to the indictment, the amount of the kickback payments ranged from $400 to $700 for each new care cycle and $100 to $300 for each re-certification. The payments were intended to induce nurses, marketers and others in the home health industry to refer patients to Goodwill for services to be reimbursed by Medicare, the indictment alleges.
      
In January 2009, Maravilla and Arroyo allegedly created and circulated to Goodwill employees and affiliates a memo on Goodwill’s letterhead that set forth a structure for kickbacks relating to patient re-certifications, disguising the illegal payments as “bonuses.” The memo provided that a $100 bonus would be given to nurses who re-certified a patient for a third cycle, and a $200 bonus would be given to a nurse who re-admitted a discharged patient a month after the discharge date.
       
In order to make certain kickback payments in cash, Maravilla and Arroyo obtained Goodwill checks payable to them and recorded on Goodwill’s books as “loans,” but they allegedly cashed the checks and used the funds to pay kickbacks to marketers.
       
The indictment alleges that Maravilla, Arroyo and Goodwill’s bookkeeper paid Echavia cash kickbacks totaling about $28,000, and also paid kickbacks totaling about $56,000 to a company owned and controlled by Echavia. Maravilla and Arroyo allegedly caused Goodwill to pay about $10,400 in kickbacks to Holloway, $21,500 in kickbacks to Shah, and $20,000 in kickbacks to two other marketers who were not charged.
       
The indictment also alleges that Maravilla and Arroyo caused Goodwill to pay at least $58,000 in kickbacks to at least three other nurses who were affiliated with Goodwill. They also were not charged. In addition to receiving salary and profits from Goodwill, Maravilla and Arroyo allegedly caused the agency to pay kickbacks to themselves, as well. Maravilla allegedly received about $138,000 in kickbacks, and Arroyo allegedly received about $44,000 in kickbacks for patients that either he or his wife referred to Goodwill.
       
Conspiracy and each count of violating the anti-kickback statute carry a maximum penalty of five years in prison and a $250,000 fine. 

The indictment was announced by Gary Shapiro, acting U.S. attorney for the Northern District; Lamont Pugh III, special agent in charge of the Chicago Region of the U.S. Department of Health and Human Services; and Robert Grant, special agent in charge of the Chicago Office of the FBI.
       
The public is reminded that an indictment is not evidence of guilt. The defendants are presumed innocent and are entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.
       
The case falls under the umbrella of the Medicare Fraud Strike Force, which expanded operations to Chicago in February 2011 and is part of the Health Care Fraud Prevention and Enforcement Action Team.  Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. 


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