CHICAGO — A former proprietor of a house visiting doctor firm in suburban Chicago, who was beforehand convicted of theft from the Medicare program, has been ordered by a federal choose to pay greater than $25 million in damages and penalties as the results of greater than 4,000 violations of the False Claims Act.
AJIBOLA AYENI, 63, of Flossmoor, previously operated DOCS AT THE DOOR, P.C., a house visiting doctor firm in Matteson, Illinois. In 2017, the federal government intervened in a sealed whistleblower lawsuit that had been introduced towards him and different defendants in 2013. The US filed its personal complaint-in-intervention towards Ayeni and his spouse, JOY H. TURNER-AYENI, 61, of Flossmoor, and their firms, together with Docs on the Door, alleging that they’d violated the federal False Claims Act by knowingly submitting claims for Medicare funds for companies not rendered, companies that weren’t medically mandatory, and companies that have been “upcoded” to the next degree reimbursement than was acceptable or supplied. The allegations included that Ayeni and Docs on the Door had submitted hundreds of claims for a Medicare service referred to as care plan oversight, which they knew had not been supplied. Care plan oversight is a lined Medicare service, the place a doctor who has licensed a plan of look after a house well being affected person spends an extra half-hour in a calendar month performing sure oversight features that aren’t associated to the certification itself or a face-to-face go to with the affected person, that are individually billed.
Additionally in 2017, Ayeni was charged in a associated legal case alleging care plan oversight fraud. That case resolved in a responsible plea on August 22, 2019, when Ayeni pleaded responsible to at least one depend of theft or embezzlement in reference to a well being care profit program. In his plea, Ayeni particularly admitted that the Medicare program paid Docs on the Door roughly $523,600 from 2011 by June 2015 as the results of 4,367 false claims for the care plan oversight service that he, because the proprietor and approved official of the enterprise, knowingly induced to be submitted though he knew that care plan oversight service had not been rendered. He additionally admitted that he instructed others to create false documentation to assist these false claims for care plan oversight.
On March 24, 2023, Chief U.S. District Decide Rebecca R. Pallmeyer granted abstract judgment to the US relating to the care plan oversight false claims in its civil case, holding that Ayeni and Docs on the Door are liable beneath the False Claims Act for these false care plan oversight claims to Medicare primarily based upon Ayeni’s earlier responsible plea and his admissions throughout the plea settlement. On March 28, 2023, the courtroom entered judgment towards Ayeni and Docs on the Door within the quantity of $25,589,300, made up of $1,570,800 in treble damages and $24,018,500 in civil penalties.
The ruling is introduced by Morris Pasqual, Appearing United States Legal professional for the Northern District of Illinois; Robert W. Wheeler, Jr., Particular Agent-in-Cost of the Chicago Workplace of the Federal Bureau of Investigation; and Mario Pinto, Particular Agent-in-Cost of the Chicago Area of the U.S. Division of Well being and Human Providers Workplace of Inspector Basic. The federal government is represented in its civil fraud case by Assistant U.S. Legal professional Sarah North. The federal government was represented within the legal case towards Ayeni by Assistant U.S. Attorneys Jeremy Daniel and Sarah North.
To fight fraud, the False Claims Act permits personal people to sue for false claims on behalf of the federal government and to share in any restoration. The Act additionally permits the federal government to intervene or take over the lawsuit, because it has achieved on this case, and to recuperate thrice damages plus civil penalties, that ranged from $5,500 to $11,000 for every false declare submitted by the defendants in the course of the fraud scheme on this case.