On Tuesday, it was announced that the United States had filed a civil lawsuit against the owners of a suburban Chicago health care company. The husband and wife owners are accused of falsely billing Medicare for millions of dollars in nonexistent or unnecessary services.
The complaint suggests that Gateway Health Systems Inc., and its owners, Ajibola Ayeni and Joy H. Turner-Ayeni, violated the False Claims Act by taking Medicare payments for home health services that were not actually needed. The suit also claims that Docs At the Door P.C., which is also owned by Ajibola Ayeni, falsely certified non-homebound individuals as needing home-health services.
Docs at the Door is accused of fraudulently upcoding home physician visits to increase Medicare compensation. The complaint was filed on Tuesday in a United States District Court in Chicago. A private citizen previously filed in 2013 under the whistleblower provisions of the False Claims Act.
58-year-old Ajibola Ayeni of Flossmoor faces additional criminal charges relating to his work with Docs at the Door. An eleven-count indictment was returned against the defendant earlier this year. It claims that Ajibola Ayeni committed health care fraud from 2011 to 2015. The defendant has pleaded not guilty. A trial date has not yet been set.
The government’s suit claims that the two companies were paid millions of dollars for services that were not rendered or not medically necessary, because the Medicare beneficiaries were not confined to their home. The suit suggests that the fraud netted the husband and wife couple millions of dollars to which they were not entitled.
The suit also implies that the defendant tried to conceal some of his assets after learning about the investigation. At this point in time, the defendants are innocent until proven guilty beyond a reasonable doubt in a court of law.