A Chicago couple has been accused of using its physical therapy business in a $45 million Medicare fraud scheme, according to a press release from the Department of Justice. The couple, Richard and Maribel Tinimbang, also allegedly attempted to force a Filipino woman into indentured servitude.

The Tinimbang case is part of a larger fraud investigation, for which three related home health care companies are accused of committing health care fraud and laundering money in order to conceal the Tinimbang scheme. Thirteen individuals face charges for that case, three of whom have already pleaded guilty. Among the other 10 awaiting trial is Richard’s mother, Josephine Tinimbang, who is also the owner of the three businesses.

Richard and Maribel Tinimbang’s physical therapy business, Patients First Physical Therapy Inc., claimed to provide in-home physical therapy services to the patients of Josephine’s three home health care companies. However, the couple is accused of bribing the companies in order to obtain Medicare beneficiaries, as well as falsifying medical records to make their patients appear sicker.

The Medicare scam resulted in $45 million in illegal profits, which the couple wrote off as business expenses. This enabled them and Josephine to spend the money on investments and luxury items, such as stock, vehicles, and jewelry. The couple also purchased a 5,000-square-foot home in Lincolnwood, Ill.

In addition to the health care fraud charges, the couple faces charges for a case of indentured servitude. Richard Tinimbang allegedly submitted fraudulent forms to the Department of Homeland Security, stating a Filipino woman would be hired as a business analyst at Josdan Home Health Care Inc., one of Josephine’s three companies. However, the couple used her to work as a nanny and housekeeper for themselves and others instead.

According to the federal indictment, the couple attempted to force the woman to sign a servitude contract by threatening to send her back to the Philippines without being paid for the work she had already done. The contract offered her daily wages of $66, regardless of the amount of hours she would be required to work. She’d also be required to work for seven years, or pay the couple $25,000 in damages if she quit before the term was up.

Richard Tinimbang is being charged with one count of conspiracy to defraud Medicare, one count of conspiracy to pay or receive health care kickbacks, two counts of paying kickbacks to induce referrals of Medicare beneficiaries, one count of money laundering conspiracy, one count of conspiracy to obtain forced labor, and one count of presenting false statements in an immigration document.

Maribel Tinimbang is being charged with one count of conspiracy to defraud Medicare, one count of money laundering conspiracy, and one count of conspiracy to obtain forced labor.

It’s estimated that cases of health care fraud add as much $98 billion to Medicare and Medicaid spending annually. Last year, 243 doctors, nurses, and other licensed medical professionals were arrested for a record-breaking $712 million Medicare scam. It was the largest Medicare fraud case to date, both in terms of the number of defendants charged and the amount of money lost. In 2012, just seven people were able to commit a record-breaking $375 million Medicare fraud scam.