In a recent case of health care fraud, a suburban Chicago doctor has been sentenced to federal prison and fined $1 million. John A. Greager II, owner of Cancer Therapy Associates S.C., pleaded guilty to submitting fraudulent claims to Medicare and Blue Cross Blue Shield of Illinois. Greager falsely stated that mole-removal procedures had been provided to patients on multiple dates, when in reality he had removed multiple moles on a single date. By misleading insurers and maximizing reimbursement, Greager ultimately received approximately $1.7 million. Furthermore, to cover up his fraudulent actions, Greager stored moles onsite and delayed sending them for pathology testing, leading to delayed diagnosis of serious illnesses. This case serves as a reminder of the importance of ethical practices in the medical field and highlights the consequences that can occur when healthcare providers engage in fraudulent activities.
Suburban Chicago Doctor Sentenced to Federal Prison for Health Care Fraud
A suburban Chicago doctor, John A. Greager II, has been sentenced to a federal prison term and fined $1 million for health care fraud. Greager pleaded guilty to submitting fraudulent claims to Medicare and a private insurer, wherein he falsely stated that mole-removal procedures had been provided to patients on multiple dates. In reality, Greager knew that the services were not provided as billed. Greager admitted to removing multiple moles on a single date but billed them as though they were removed on separate dates to maximize reimbursement. The fraudulent scheme resulted in Greager receiving approximately $1.7 million from Medicare and Blue Cross Blue Shield. Greager also concealed his fraudulent conduct by storing moles onsite and delaying pathology testing, creating fake patient charts, and instructing his staff to create false records. The sentence, imposed by U.S. District Judge Robert W. Gettleman, includes a 6-month prison term and a $1 million fine.
The case against John A. Greager II involves his ownership and operation of Cancer Therapy Associates S.C., located in Lombard, Illinois. From 2015 to 2021, Greager engaged in health care fraud by submitting fraudulent claims to Medicare and Blue Cross Blue Shield. These claims falsely stated that mole-removal procedures had been provided to patients on separate dates, when in reality, Greager had removed multiple moles on a single date. The purpose of this fraudulent billing was to maximize reimbursement from the insurers. Greager admitted to being aware that insurers paid more for moles removed on separate dates, leading to him receiving approximately $1.7 million through his scheme.
Sentence and Fine
U.S. District Judge Robert W. Gettleman presided over the case and imposed a sentence of 6 months in federal prison on John A. Greager II. In addition, Greager was fined $1 million for his health care fraud conviction. The sentence and fine serve as consequences for Greager’s participation in the fraudulent scheme involving the submission of false claims to Medicare and Blue Cross Blue Shield.
Background of the Doctor
John A. Greager II is a 75-year-old doctor based in Hinsdale, Illinois. He owned and operated Cancer Therapy Associates S.C. in Lombard, where the health care fraud took place. Greager’s medical background and experience in the industry contribute to the severity of his fraudulent actions. As a trusted medical professional, Greager violated the trust placed in him by both patients and the health care system.
The fraudulent claims involved mole-removal procedures that Greager falsely stated were performed on separate dates. In reality, multiple moles were removed on a single date, but Greager billed them as though they were removed on different dates. The purpose of this fraudulent billing was to increase the reimbursement received from Medicare and Blue Cross Blue Shield. By manipulating billing practices, Greager fraudulently obtained approximately $1.7 million from the insurers.
Concealing Fraudulent Conduct
To conceal his fraudulent conduct, Greager took several steps to manipulate records and mislead auditors. One method Greager employed was storing moles onsite at his office and deliberately delaying sending them for pathology testing. By doing so, Greager created the appearance that moles were removed on separate dates, aligning with the false claims submitted for reimbursement. Greager also created fake patient charts, including pre-operative and post-operative notes, indicating that he had performed mole-removal procedures on dates when he was not even in Illinois. These false records were intended to hide the fact that Greager committed health care fraud when Medicare conducted an audit of his patient charts.
Delayed Testing on Moles
As a result of Greager’s fraudulent conduct and the delayed pathology testing, important diagnostic information was hindered. Delaying the testing on moles removed for serious illnesses, such as cancer, can have significant consequences for patients. Greager’s actions may have prolonged the diagnosis and treatment of life-threatening conditions, potentially putting patients’ health at risk.
Fake Patient Charts
In an effort to deceive auditors and hide his fraudulent activities, Greager created fake patient charts. These charts included pre-operative and post-operative notes indicating that he had performed mole-removal procedures on dates when he was not present in Illinois. By fabricating these records, Greager attempted to cover up his health care fraud and evade detection during the Medicare audit. However, his fraudulent actions were eventually uncovered, leading to his guilty plea and subsequent sentencing.
Government Agencies Involved
Several government agencies were involved in the investigation and prosecution of John A. Greager II for health care fraud. These agencies include the FBI, the U.S. Department of Health and Human Services’ Office of the Inspector General, the U.S. Department of Labor’s Office of Inspector General in Chicago, and the U.S. Office of Personnel Management’s Office of the Inspector General. Together, these agencies collaborated to uncover the extent of Greager’s fraudulent activities and ensure that he was held accountable for his actions.
Prosecution and Representation
The prosecution of John A. Greager II was carried out by the U.S. Attorney’s Office for the Northern District of Illinois. Assistant U.S. Attorneys Jared Hasten and Virginia Hancock represented the government in the case. Their efforts were instrumental in securing Greager’s guilty plea and subsequent sentencing. The U.S. Attorney’s Office, along with other government agencies involved, demonstrated their commitment to combating health care fraud and protecting the integrity of the health care system.
To further understand the extent of health care fraud and its impact on society, it is important to explore related cases and issues. One such case is that of a former Illinois Department of Children and Family Services employee and 14 others charged in a $3.2 million fraud scheme. Another case involves three board members of a failed Washington Federal Bank in Chicago who were found guilty of falsifying records and obstructing regulators. These cases highlight the prevalence of fraud within various sectors and the ongoing efforts to detect and prosecute those responsible.
In conclusion, the sentencing of John A. Greager II to federal prison and the imposition of a $1 million fine serve as a significant step in combating health care fraud. Greager’s fraudulent actions, which included submitting false claims to Medicare and Blue Cross Blue Shield, compromised the integrity of the health care system and potentially put patients’ health at risk. The collaboration of government agencies and the diligent efforts of the prosecution have ensured that Greager is held accountable for his crimes. These actions send a strong message that health care fraud will not be tolerated and that those who engage in such activities will face severe consequences.