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Elmhurst woman charged in Medicare scheme

Published: Thursday, May 16, 2013 3:20 p.m. CDT • Updated: Thursday, May 16, 2013 5:57 p.m. CDT

ELMHURST – An Elmhurst woman is facing one count of healthcare fraud after she allegedly took part in a false Medicare billing scheme.

Ellyse Lamon, 30, of Elmhurst, was one of seven Chicago-area defendants charged. Lamon allegedly engaged in a $350,000 Medicare false billing scheme between October 2010 and May 2011 while she worked as an account executive for a company that sold durable medical equipment.

The charge carries a maximum penalty of 10 years in prison and a $250,000 fine, according to information filed by the U.S. Attorney's Office this week.

Prosecutors allege Lamon caused her company to submit false claims to Medicare, saying a physician had prescribed back braces and transcutaneous electrical nerve stimulation units when she knew that no physician had done so and the items were not medically necessary. She also allegedly obtained patient records without permission and added false information to substantiate the fake Medicare claims.

In addition, Lamon allegedly forged doctors' signatures on false treatment records she created, inappropriately accessed patient information at a pain medicine center in Chicago, set up meetings with patients and told them doctors had prescribed medical equipment provided by her company for them.

According to the U.S. Attorney's Office, Lamon submitted false claims to Medicare totaling $352,685, resulting in payment of at least $206,233 to the company for which she worked. She allegedly received increased commissions and other benefits as a result.

This case was investigated by the FBI and is not part of the Medicare Fraud Strike Force operation.

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