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LOS ANGELES – A San Fernando Valley girl pleaded responsible at present to federal felony costs for conspiring to defraud medical health insurance firms by inflicting tens of millions of {dollars} in fraudulent claims to be submitted to supply sufferers with “free” beauty procedures, together with Botox injections.
Roshanak Khadem, 54, a.okay.a. “Roxanne Khadem” and “Roxy Khadem,” of Sherman Oaks, pleaded responsible to at least one rely of conspiracy to commit well being care fraud and one rely of subscribing to a false revenue tax return.
In line with her plea settlement, Khadem owned and operated services that supplied aesthetic providers to purchasers, together with R&R Med Spa in Valley Village and Nu-Me Aesthetic and Anti-Ageing Heart in Woodland Hills.
From January 2012 to April 2016, Khadem triggered sufferers to go to her clinics to obtain beauty procedures, together with Botox injections, facials and laser hair elimination. Khadem knew these procedures weren’t lined by the sufferers’ well being insurers. Khadem additionally knew that her workers knowledgeable some sufferers that, in the event that they turned over their medical health insurance info to the Khadem-owned clinics, the sufferers may obtain free or discounted beauty procedures pursuant to a “credit score” they might earn.
Medical health insurance info from these sufferers was supplied to the insurance coverage biller for the clinics, figuring out and intending that the knowledge can be used to submit false and fraudulent claims to the well being insurers for medical procedures that Khadem knew have been both not truly supplied to the sufferers or weren’t medically crucial.
Then, based mostly on the quantity that the well being insurers paid on these false and fraudulent claims, Khadem and others would calculate an quantity, which the co-conspirators known as a “credit score,” that the sufferers may use to obtain free or discounted beauty procedures from the clinics. These sufferers would then come into the clinics to obtain the free or discounted beauty procedures.
The proceeds from the well being care fraud conspiracy have been deposited into financial institution accounts that have been held within the names of medical doctors who have been affiliated with the clinics and who signed off on and triggered to be submitted the false and fraudulent claims underneath their names.
Khadem took possession of the proceeds from the medical doctors’ accounts in two methods. First, as a result of Khadem had signatory authority on the financial institution accounts, she was in a position to acquire the funds by writing checks on the accounts. Second, she would
withdraw funds from the financial institution accounts utilizing pre-signed checks that she obtained from the medical doctors.
From January 2012 to April 2016, Khadem and her co-conspirators submitted claims, which included false and fraudulent claims for which these firms paid out at the very least $1,361,200.
Prosecutors estimate the quantities paid based mostly on false and fraudulent claims submitted as a part of the well being care fraud conspiracy by which Khadem participated could possibly be as a lot as $7,991,406.
The scheme involving the 2 clinics defrauded the Worldwide Longshore and Warehouse Union, Pacific Maritime Affiliation Profit Plan, which is the well being profit plan that covers longshore employees in Southern California and their dependents. One other sufferer was the Federal Staff Well being Advantages Program, which gives medical health insurance for federal workers.
Khadem didn’t report this revenue on her revenue tax returns for 2013, 2014 and 2015. Khadem’s underreporting of her revenue for these three years triggered a complete tax lack of $453,451.
United States District Decide Stephen V. Wilson has scheduled a June 27 sentencing listening to, at which period Khadem will face a statutory most sentence of 13 years in federal jail.
The remaining 4 defendants on this case every have pleaded responsible. Lucine Ilangezyan, 42, of North Hills, pleaded responsible to at least one rely of conspiracy to commit well being fraud, and was sentenced to 18 months in federal jail. Gary Jizmejian, 48, of Santa Clarita, a former senior investigator on the Anthem Particular Investigations Unit, the anti-fraud unit inside Anthem that’s chargeable for investigating well being care fraud dedicated towards the insurance coverage firm, pleaded responsible to utilizing his cellphone to ship textual content messages to co-defendants as a part of a this industrial bribery scheme– was additionally sentenced to 18 months in federal jail.
Dr. Roberto Mariano, 63, of Rancho Cucamonga, a doctor who helped function the clinics, and Marina Sarkisyan, 52, of Panorama Metropolis, who was the workplace supervisor on the clinics, await sentencing.
America Division of Labor, Workplace of Inspector Common; the US Division of Labor, Worker Advantages Safety Administration; Inner Income Service-Felony Investigations, and the Workplace of Personnel Administration, Workplace of Inspector Common investigated this matter. America Marshals Service supplied help referring to the asset forfeiture investigation.
Assistant United States Attorneys Valerie L. Makarewicz of the Main Frauds Part and Morgan J. Cohen of the Common Crimes Part are prosecuting this case.
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