Henry Smilie fraud case

**Henry Smilie** is an American fraudster and former CEO of Home Physician Services who, from 2012 to 2014, submitted nearly $2,000,000 worth of false Medicare claims and defrauded the program of around $1,200,000. After an investigation, he was arrested in 2015, and in 2022, he was sentenced to 1 year in prison.

## Background

Henry Smilie, a Lake Zurich, Illinois resident born in either 1960 or 1961, was the owner and Chief Executive Officer (CEO) of Home Physician Services LLC, a Chicago-based healthcare company. The company primarily provided healthcare to patients who were elderly and confined to their home.

Home Physician Services owned two offices; one in Chicago and one in Schaumburg. The Chicago office was located at 6002 North Keating Avenue, and acted as the company's headquarters.

## Fraud scheme

Beginning in February 2012, Smilie submitted false insurance claims to Medicare, requesting funds for in-home health care services, or "care plan oversight".  Over the course of the next two years, Smilie continually filed false claims to the program that eventually totaled around $1,970,000. By July 2014, at which point the scheme ended, Medicare had provided at least $1,200,000 worth of false insurance money to Home Physician Services.

Several employees at the company complained of the seemingly fraudulent practices to Smilie. One former employee, identified in the police affidavit as "Individual F", claimed that Smilie had instructed them how to fill certain paperwork so as to maximize the amount of money they received from Medicare. Another employee, identified as "Individual H", claimed Smilie would bill Medicare $1,000 for every swab performed on a patient. Employees were told to extend the duration of a patient's treatment beyond what was necessary in order to receive more money from Medicare, and if they could not find legitimate reasons to extend the treatment, they were told to simply "make it up".

Once when Smilie was informed by a colleague that some of his activities may be illegal, he reportedly laughed and acknowledged that much of the company's activities were against the law.

## Investigation, arrest, and trial

In 2015, police caught wind of the seemingly illegal practices conducted at the company. An undercover investigator posed as a 71-year-old seeking the company's treatment. In paperwork and bills, the company listed the investigator as confined to his home, despite him being perfectly able-bodied and regularly seen walking around his neighborhood.

On August 6, 2015, based on the investigator's treatment experience and statements from employees, police searched the offices of Home Physician Services. Smilie was simultaneously arrested and charged with federal health care fraud, a charge to which he pleaded guilty. Prosecutors stated that many of the fraudulent claims were for care plans that did not exist or were "far less intricate than portrayed in the claims submitted by Smilie's company to Medicare".

Smilie's trial did not take place until roughly 7 years later. On June 7, 2022, Smilie was sentenced to 1 year and 1 day in federal prison, and was ordered to return the $1,200,000 that he had defrauded from Medicare. Assistant U.S. attorney Kartik K. Raman called Smilie's fraud case "a significant one" and stated that, "In a world that has limited funds to pay for health care, and where budgets are ever-tightening, Medicare paid Smilie and his company for fraudulent claims that could have been used to pay for necessary medical services elsewhere."

## Citations

1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 https://www.lakemchenryscanner.com/2022/06/08/lake-zurich-man-who-was-a-healthcare-company-ceo-sentenced-to-year-in-prison-for-defrauding-medicare-of-1-2-million/
2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 https://www.justice.gov/usao-ndil/pr/ceo-chicago-based-health-care-company-charged-billing-medicare-phony-and-non-existent
3. ↑ 3.0 3.1 https://www.justice.gov/usao-ndil/pr/former-owner-chicago-health-care-company-sentenced-year-federal-prison-billing-medicare