Pinoy accused of $40-M US Medicare fraud falls

MANILA, Philippines - A Filipino accused of defrauding the United States government’s Medicare program of $40 million was arrested by National Bureau of Investigation (NBI) in Davao City recently, an official said yesterday.

According to records provided by NBI Foreign Liaison Division (FLD) chief Claro de Castro Jr., Omar Agang-Ang Decendario, 40, who used to work at the Sunrise Nursing Registry in California, faces at least 200 years in jail and a fine of $5.2 million if convicted on one count of conspiracy to commit health care fraud, 18 counts of health care fraud and one count of making false statements.

NBI-FLD agent Jose Gabriel Jr. and NBI-Region 11 special investigators James Thadeo Calleja and Gerald Intes caught Decendario at the Panacee Diagnostic Clinic in Davao City on Aug. 9.

Decendario was brought to the NBI’s regional office before he was flown to Manila on Aug. 10. De Castro said the suspect, detained at the NBI jail, will be extradited to the US.

In 2007, a district court in California issued a warrant for Decendario’s arrest after he was indicted by a federal grand jury. De Castro said the suspect’s arrest stemmed from a petition for extradition filed by the Department of Justice on behalf of the US government.

A warrant for Decendario’s arrest was issued on July 22 by Manila Regional Trial Court Judge Felixberto Olalia.

Records provided by the US government to the NBI show that Decendario and several others allegedly conspired to execute a scheme to defraud the federally funded health care program for the elderly and the disabled from 2002 to 2003.

Decendario and the other suspects reportedly recruited Medicare beneficiaries to receive home health care services, then hired health care practitioners – nurses, physical therapists, and occupational therapists – to sign forms to falsely attest they had conducted skilled nursing visits to the beneficiaries.

All the suspects reportedly falsified daily route sheets and skilled nursing notes to make it appear that the beneficiaries received skilled nursing visits.

The signatories were paid from $100 to $200 per application health form.

Based on the fraudulent health care forms, Provident Home Health then billed Medicare for home health services to beneficiaries who are not homebound and who had not received skilled nursing visits.

Provident is a home health agency that provides certain types of medical treatment, including home health services, paid by Medicare. It had an agreement with Sunrise Nursing Registry, which provides nursing services to beneficiaries qualified to receive home health services.