Federal Grand Jury Indicts Doctor for Allegedly Approving Medically Unnecessary Tests Billed to Medicare

CHICAGO — A federal grand jury in Chicago has indicted a physician on fraud charges for allegedly approving medically unnecessary diagnostic tests that were billed to Medicare.

While working for Chicago-based Grand Medical Clinic Inc., DR. OMAR GARCIA prescribed and authorized ultrasounds, percutaneous allergen tests and nerve transmission tests for numerous Medicare beneficiaries, knowing that the in-home tests were not medically necessary.  In some instances, Dr. Garcia approved the tests after they had already been completed, the indictment states.  Dr. Garcia and others submitted or caused to be submitted fraudulent claims to Medicare for payment of the unnecessary tests, the indictment states.

The indictment was returned Thursday in U.S. District Court in Chicago.  It charges Dr. Garcia, 51, of Ocala, Fla., and formerly of Illinois, with six counts of health care fraud.  Arraignment has not yet been scheduled.

The indictment was announced by John R. Lausch, Jr., United States Attorney for the Northern District of Illinois; Jeffrey S. Sallet, Special Agent-in-Charge of the Chicago office of the Federal Bureau of Investigation; Lamont Pugh III, Special Agent-in-Charge of the Chicago Region of the U.S. Department of Health and Human Services Office of Inspector General; and Martin J. Dickman, Inspector General  of the U.S. Railroad Retirement Board.  The U.S. Office of Personnel Management and the U.S. Food and Drug Administration provided valuable assistance.  The government is represented by Assistant U.S. Attorney Stephen Chahn Lee.

The indictment alleges that Dr. Garcia’s fraud scheme began in 2011 and continued until 2015.  Dr. Garcia and others submitted the fraudulent bills from multiple medical entities in an attempt to reduce the volume of billing by any single company and minimize scrutiny from Medicare, the indictment states.  After the entities received payments from Medicare, Dr. Garcia was paid via checks reflecting his percentage of the payments, the indictment alleges.

The public is reminded that an indictment is not evidence of guilt.  The defendant is presumed innocent and entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.  Each count in the indictment is punishable by a maximum sentence of ten years in prison.   If convicted, the Court must impose a reasonable sentence under federal statutes and the advisory U.S. Sentencing Guidelines.