U.S. Attorney Patrick Fitzgerald charged two Chicago-area physicians in separate cases of healthcare fraud, one of whom allegedly collected more than $13 million from Medicare and private insurers for treatment he never provided.
In court documents filed Jan. 28 in U.S. District Court in Chicago, Fitzgerald alleges that cardiologist Sushil Sheth, whose office is in south suburban Flossmoor, obtained patient names, insurance information and dates during which those patients were admitted to hospitals where he held staff privileges. Between 2002 and 2007, Sheth billed $8.3 million to Medicare and $5.1 million to other insurers for intensive cardiac care he purportedly provided on multiple days during those stays, Fitzgerald alleged.
On Jan. 29, Fitzgerald charged Otto Garcia Montenegro with healthcare fraud for an alleged scheme in which his clinic in the western suburb of Elmwood Park submitted fraudulent claims totaling about $500,000 in order to exhaust patients deductibles, as well as collect payment for himself.
Fitzgerald also announced a grand jury indictment against the proprietor and an employee of two former durable medical-equipment businesses in the Chicago area. The indictment was unsealed after the Jan. 23 arrest in Sugarland, Texas, of the business owner, Stephen Pam. Pam and codefendant Shavon Williams are accused of submitting more than $5 million in fraudulent DME claims to Medicare and Medicaid.