Jury acquits Chicago doctor of $1.6M Medicare fraud; 4 others guilty, await sentencing

by Joseph G. Lariosa

CHICAGO (JGL) – Dr. Victoria “Vicky” Gallardo Navarra of Bloomfield Hills, Michigan was acquitted while a nurse pleaded guilty during the jury trial. Three others, including a doctor and a nurse, pleaded guilty before the start of the trial on a scheme involving approximately $1.6 million in fraudulent Medicare claims for home health services that were procured through the payment of kickbacks, and that were medically unnecessary and not provided.

“It was a harrowing experience and I would not wish it on anyone,” Dr. Navarra, widow of the late Eduardo Navarra, the fifth national chair of National Federation of Filipino American Associations (NaFFAA), told this reporter. “After four hours of deliberation, the jury found me not guilty of the charge of one count of conspiracy to commit Medicare fraud.”

Editha Manzano, 69, of Troy, Michigan, was convicted of one count of conspiracy to commit health care and wire fraud, one count of conspiracy to pay and receive kickbacks in connection with Medicare beneficiaries, and one count of health care fraud following a seven-day trial.

Manzano, co-owner, controller, and manager of Anointed Care Services, a home health care agency, in Detroit, Michigan, is up for sentencing on April 19, 2018, before U.S. District Court Judge Gershwin Drain of the Eastern District of Michigan who presided over the trial.

The three others awaiting sentencing are Roberto Quizon, 71, a licensed physician, of Bloomfield Hills, Michigan and owner of Green Cross Medical Center in Detroit, Michigan and (Mr.) Liberty Jaramillo, 67, co-owner, controller and manager of Anointed Care Services, of Troy, Michigan, who both pleaded guilty in June 2017 and Juan Yrorita, 63, a registered nurse and assistant director of Anointed Care Services, of Sterling Heights, Michigan, who pleaded guilty during the trial.

All defendants charged with conspiracy to commit health care, wire fraud 

All the defendants were charged with Count 1 conspiracy to commit health care fraud and wire fraud; Editha Manzano and Liberty Jaramillo were both charged with Count 2 conspiracy to pay and receive health care kickbacks; and Manzano, Jaramillo, and Quizon were charged with Counts 3-5 for health care fraud.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, Acting U.S. Attorney Daniel L. Lemisch of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement of the outcome of the case.

According to evidence presented at trial, from 2013 to 2016, Manzano and her co-conspirators engaged in a scheme to defraud Medicare of approximately $1.6 million in fraudulent claims for home health care services in connection with Anointed Care Services.

Manzano paid illegal kickbacks 

The evidence showed that Manzano paid illegal kickbacks for patients to sign up for home health care with Anointed. She conspired with physicians to admit patients for home health care when they did not qualify for such services.

To make it appear that these patients did qualify, Manzano and her co-conspirators falsified medical records and signed false documents purporting to show that patients admitted to Anointed’s home health program satisfied Medicare’s requirements for admission, the evidence showed.

The penalty for the charges of conspiracy to commit health care fraud for violation of 18 U.S.C. Sec. 1349 is maximum of 20 years of imprisonment and a “fine that is greater than $250,000 or twice the pecuniary gain or loss pursuant to 18 U.S. Code Sec. 3571(d) and a three-year term of supervised release.”

Navarra said she saw Anointed’s patients “just to do a favor when the owner begged me to see her patients because no one has been seeing them and they were all ‘sick’.

“I saw them on a few weekends when I was free. When I heard rumors that they were not on the up and up, I stopped seeing their patients,”  Navarro said.

Arrested 3 days after husband’s funeral 

She recalled the FBI agents came to her home without letting her know she was a suspect.  She told them that “she did know specific details of any wrongdoing and I have not spoken to the (home health) owner since she stopped their patients in September 2015.”  She said she did not hear from them until she was arrested three days after her husband’s funeral.

“It was the most humiliating experience I have ever had in all my life,” Navarra said.   “It looked like a SWAT team barging into my home on TV. Immediately, I was brought to the Federal Building, waited until morning to be arraigned then discharged home to wait for my trial in court.”

Eduardo Navarra, a former two-time (2010-2014) national chair of NaFFAA died of a massive stroke on Aug. 26, 2016, three weeks after attending the three-day 12th National Economic Empowerment Conference of NaFFAA in King of Prussia, Pennsylvania.

Navarra said the court dates were postponed six times before the trial finally got underway on Nov. 21, 2017.  She complimented her lawyer saying he was excellent. She initially thought that she would be dropped from the case since “he did not see anything wrong with my conduct in the case. But the government (prosecutors from Washington, D.C.), including seven to eight lawyers and several “special agents,” persisted. Navarra said the government spent $2-M to convict her.

Thank supporters in courtroom, the U.S., the Philippines and New Zealand 

She said the agents said “no” on cross-examination if she received a penny from the home health care or “I don’t know” when asked about “questions salient to the investigations regarding my involvement.”

When she was acquitted, her friends who have been faithfully attending her trial cried and hugged each other. “I was ecstatic, of course, but too numb to say anything. I thank God, my lawyer and all my friends who supported me here in the U.S., the Philippines, and New Zealand.

“My two witnesses to my character and integrity helped, too, and in spite of the lying prosecutors and witnesses. The jury obviously saw through them and found me not guilty. Thank God!,” Navarra said.

Before the trial, Navarra was free on her own recognizance but had to surrender her US passport to the authorities, which was returned to her after her acquittal.

Navarra is now preparing for her next annual medical mission in San Jose, Nueva Ecija in the Philippines from February 12 to 16. “God is good because I even found enough sky miles to pay for my trip. “I have been on ‘automatic’ since all of these happened,” she quipped.

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