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A Chicago case shows strong local focus on healthcare fraud

In 2015, James Ademiju, a Chicago area registered nurse, was arrested on healthcare fraud charges.

Simultaneously, joint law enforcement agencies under the auspices of the Medicare Fraud Strike Force began a search of the healthcare companies implicated in the criminal complaint against Ademiju.

What happened

James Ademiju worked at two nursing agencies, Adonis, where he was an office manager, and BestMedicare Services, where he was an administrator. These companies allegedly acquired many patients through marketing company referrals. The complaint against Ademiju charged that he engaged in defrauding Medicare by billing for unnecessary nursing services. Between 2011 and 2014, Medicare paid a total of $5 million to the two companies for skilled nursing services that patients either did not qualify for or did not need.

The Strike Force

The Medicare Fraud Strike Force is primarily made up of agents from both the FBI and the Department of Health and Human Services, Office of Inspector General. As part of the Health Care Fraud Prevention & Enforcement Action Team, an initiative that opened in 2009 between the Justice Department’s Fraud Section and the US Attorney’s Office, it has operated in the Chicago area since 2011. The strike force's work led to one count of healthcare fraud against Ademiju. Penalties included a fine of $250,000 and up to 10 years in prison. Such a conviction is also accompanied by mandatory restitution.

A lengthy process

An investigation into the possibility of fraudulent activities is normally a lengthy process that can take months or even years. If an investigation of your employer is underway and you think that you may be a target, it is best to explore your legal options promptly rather than wait for the filing of charges. Eventually, investigators will begin interviewing people, and you have the right to have an attorney present. If you require defense, you can expect a vigorous dispute of the charges against you. Even if you are not implicated, having legal representation will afford you peace of mind.

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