Home health executive convicted of Medicare fraud, ordered to pay $15M

The former manager of Schaumburg, Ill.-based Suburban Home Physicians was convicted of Medicare fraud and sentenced to six years in prison, according to a Sun-Times report.

Diana Gumila was convicted on 21 counts of healthcare fraud and three counts of falsifying statements regarding healthcare issues, according to a statement released by the U.S. Attorney's office.

A judge ordered Ms. Gumila to pay $15.6 million in restitution, in addition to serving six years in prison for her role in the scheme.

According to the report, Ms. Gumila directed employees to make house calls to patients who didn't need at-home care. Ms. Gumila also told employees to bill Medicare more than the amount generally accepted for routine visits.

In audio played during the trial, Ms. Gumila was overheard telling new physicians to make it appear as if patients were confined to their homes. The jury also read an email from Ms. Gumila condoning the hiring of a new physician because he "[would] do what [company executives] would tell him to do," according to the report.

Ms. Gumila is one of three people convicted in the scheme. The two accomplices were found guilty of defrauding Medicare, billing for unnecessary services and making illegal payments for patient referrals. Further proceedings in both cases have yet to be disclosed.

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