Physician, Chiropractor Facing Healthcare Fraud Charges
A Chicago-area chiropractor and physician are facing federal healthcare fraud charges after being accused of bilking four large insurance companies out of millions of dollars.
The physician, Eguert Nagaj, M.D., and the chiropractor, Igor Sher, operated three separate medical and chiropractic practices in the town of Buffalo Grove. They were among six people involved in the alleged scheme named in indictments that were unsealed in federal court earlier this week. Both are facing 16 counts of mail fraud, with an additional obstruction of justice charge against Sher.
According to the indictment, Sher and Nagaj recruited individuals with health insurance, and then billed their carriers for chiropractic services that were never performed. Altogether, Blue Cross Blue Shield of Illinois, Aetna, UnitedHealthcare, and Allstate Fire and Casualty Insurance Co. were fraudulently billed nearly $3 million, the indictment alleges.
The recruited patients were paid kickbacks out of the paid claims, or had their annual deductibles falsely satisfied. They were also encouraged by office staff to lie when contacted by investigators, according to prosecutors.
Federal prosecutors allege that the scheme was carried on for more than a decade, starting in 2003 and not concluding until January 2014.
Three would-be patients were also indicted, along with a billing manager for the three practices.
An arraignment date for the defendants has not yet been announced.
Although this investigation mostly concerned commercial healthcare fraud, a joint operation by the U.S. Justice Department and the U.S. Department of Health and Human Services has been extremely aggressive regarding Medicare and Medicaid fraud in recent years.
According to a recent report released by the agencies, their joint initiative, known as Health Care Fraud Prevention and Enforcement Teams, or HEAT, has helped to recover $19.2 billion in fraudulent charges over the past five years, recouping more than $8 for every taxpayer dollar spent on recovery and enforcement efforts.
“Thanks to initiatives like HEAT, our work to combat fraud has never been more cooperative or more effective,” said U.S. Attorney General Eric Holder. “And our unprecedented commitment to holding criminals accountable, and securing remarkable results for American taxpayers, is paying dividends.”
