The head of a Chicago-based company that manages physicians who make house calls and one of its most prolific doctors were arrested Tuesday on charges the company fraudulently billed Medicare for millions of dollars by inflating the level of care given patients.
A criminal complaint charged Dike Ajiri, chief executive officer of Mobile Doctors, with health care fraud and Banio Koroma, a physician who has worked for the company since 2007, with making false statements.
Federal agents raided Mobile Doctors' headquarters in the 3300 block of North Elston Avenue and branch offices in Detroit and Indianapolis and also sought to seize about $2.6 million in alleged fraudulent proceeds from various bank accounts, prosecutors said.
During a brief hearing at the Dirksen U.S. Courthouse, U.S. Magistrate Judge Mary Rowland ordered Ajiri, 42, of Wilmette, held in custody at least until a detention hearing Thursday. Koroma, 63, of Tinley Park, was freed on $50,000 bail but barred from contact with patients.
Before the hearing, Ajiri, a former college football and rugby player, stood with his hands cuffed behind his back, joking with supporters in the courtroom.
Prosecutors said that Mobile Doctors operates in six states, arranging hundreds of thousands of home visits and contracting with doctors who perform the visits. Current and former employees and doctors told investigators that a typical visit with a patient lasts 10 to 30 minutes and is routine in nature.
But according to the charges, Ajiri schemed over the last seven years to increase Medicare billings by falsely claiming the patient visits were more complicated and took longer than they actually did.
A former manager of the Chicago office told investigators that Ajiri set up a system so that the two highest fee codes allowed by Medicare automatically kicked in so that patient visits would be worth the doctors' time and the cost of gas, according to prosecutors.
According to the complaint, the manager quoted Ajiri as telling his physicians, "I don't pay for the ones or twos," a reference to the lower fee codes. From 2006 to 2012, Mobile Doctors received more than $34 million in payments on claims using the two higher codes, according to the charges.
The charges also alleged that Mobile Doctors' physicians falsely certified that patients they visited were confined to their homes, enabling home health care agencies to claim fees for additional services for patients who were not actually qualified to receive them.
Some 16,000 patients had been certified as homebound by the company since 2006, leading to more than 83,000 home health visits, many of them fraudulent, according to prosecutors. Koroma alone accounted for more than 6,000 of the certifications and allegedly billed Medicare for about 17,500 patient visits he made, more than any other Mobile Doctors physician, prosecutors said.Copyright © 2015, CT Now