Best Defender Bytes:

LOS ANGELES – A San Fernando Valley chiropractor, who was the second highest Medicare biller in California for chiropractic services, pled guilty yesterday to healthcare fraud in violation of 18 U.S.C. § 1347.

Between 2005 and 2012, Houshang Pavehzadeh aka “Danny Paveh” (41), owner of Sylmar Physician Medical Group, Inc. – a storefront chiropractic clinic located in a strip mall – defrauded Medicare by billing for patients he never treated.

The eleven count indictment alleges that Pavehzadeh submitted over $1.7 million in false and fraudulent claims to Medicare and was paid a little over $1 million on these claims. As part of his guilty plea, Pavehzadeh admitted that, in an effort to conceal his fraud from Medicare auditors, he staged an early-morning car jacking outside his office and falsely reported to the Los Angeles Police Department that his patient files had been stolen.

“Those persons who seek to bilk the Medicare Program impact both our health care delivery system and the American consumer,” said United States Attorney André Birotte Jr. “Here, the defendant not only tried to bilk the system to the tune of more than $1.7 million, he also had the audacity to try and conceal his criminal activity by filing a bogus police report with the LAPD.”

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Kan-Di-Ki LLC, formerly known as Kan-Di-Ki Inc., doing business as Diagnostic Laboratories and Radiology (Diagnostic Labs), will pay $17.5 million to settle allegations that the California-based company violated the federal and California False Claims Acts by paying kickbacks for referral of mobile lab and radiology services subsequently billed to Medicare and Medi-Cal (the state of California’s Medicaid program), the Justice Department announced today.

“This settlement demonstrates the Department of Justice’s continuing efforts to protect public funds,” said Stuart F. Delery, Assistant Attorney General for the Civil Division.  “We will continue to work with our state partners to recover misspent monies from companies that abuse government health care programs.”

Diagnostic Labs allegedly took advantage of Medicare’s different reimbursement system for inpatient and outpatient services by charging Skilled Nursing Facilities (SNFs) in California discounted rates for inpatient services paid by Medicare in exchange for the facilities’ referral of outpatient business to Diagnostic Labs.  For inpatient services, Medicare pays a fixed rate based on the patient’s diagnosis, regardless of specific services provided.  For outpatients, Medicare pays for each service separately.  Diagnostic Labs’ scheme enabled the SNFs to maximize profit earned for providing inpatient services by decreasing SNFs’ costs of providing these services.  It also allegedly allowed Diagnostic Labs to obtain a steady stream of lucrative outpatient referrals that it could directly bill to Medicare and Medi-Cal.  The provision of inducements, including discounted rates, to generate referrals is prohibited by federal and state law.

“When medical facility owners illegally offer discounts to customers to generate business, it results in inflated claims to government health care programs and increases costs for all taxpayers,” said Glenn R. Ferry, Special Agent in Charge for the Los Angeles Region of the Department of Health and Human Services’ Office of Inspector General.  “This $17.5 million settlement demonstrates OIG’s ongoing commitment to safeguarding federal health care programs and taxpayer dollars against all types of fraudulent activities.”

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Jing Wang, 51, of Del Mar, Calif., a former Executive Vice President and President of Global Business Operations for Qualcomm Inc., was charged with insider trading in shares of both Qualcomm and Atheros Communications Inc. using a secret brokerage account and an offshore shell company in the British Virgin Islands.  Wang was also charged with conspiring with his brother, co-defendant Bing Wang, 53, and his former stock broker to obstruct an ongoing U.S. Securities and Exchange Commission (SEC) investigation and laundering the proceeds of his insider trading using a second offshore shell company and secret brokerage account.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division and U.S. Attorney Laura E. Duffy of the Southern District of California made the announcement.

“Insider trading is an insidious crime.  It undermines ordinary investors’ faith in our financial markets, and the Justice Department has zero tolerance for it,” said Acting Assistant Attorney General Raman.  “Today’s charges show that you cannot trade on inside information, pocket the profit, and expect to get away with it.  The Criminal Division has had a terrific partnership with the U.S. Attorney’s Office for the Southern District of California in this important investigation, and through partnerships like these throughout the country, we will continue to root out fraud in our markets at every level.”

“When there are two sets of rules – one for the powerful insiders and one for everybody else – the public quickly loses confidence in the stock market,” said U.S. Attorney Duffy. “We intend to restore confidence in our markets by making sure that everyone is playing by the same rules.”

Jing Wang was taken into custody by the FBI earlier today on these charges and is expected to make his initial appearance in federal court in the Southern District of California this afternoon.  A warrant has been issued for the arrest of Bing Wang, who is believed to be a citizen and resident of China.  Both men are charged in an indictment with conspiracy, which carries a maximum penalty of five years in prison. Jing Wang was also charged with securities fraud, money laundering and obstruction of official proceedings, which each carry a maximum penalty of 20 years in prison, and aggravated identity theft, which carries a mandatory two years in prison, consecutive to any other sentence.

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Federal and State Grand Juries Indict 129 Defendants who Allegedly Assisted the Prison Gang or Were Involved in the Business of Numerous O.C. Street Gangs

SANTA ANA, California – Hundreds of law enforcement officials this morning fanned out across Southern California to conclude Operation “Smokin’ Aces,” an investigation conducted by the Santa Ana Gang Task Force that targeted the Orange County wing of the Mexican Mafia, which allegedly exercises control over Latino street gangs and is a powerful force in the local jail system.

A total of 129 defendants have been named in indictments issued by county and federal grand juries. Each of the defendants is linked to an Orange County street gang that claims allegiance to the Mexican Mafia, which is also called the Eme. Some of the federal defendants also are associates of the prison gang who allegedly worked directly with one of the two Mexican Mafia members who oversee the Orange County wing of the criminal enterprise.

During the course of the investigation, task force members made undercover purchases of 67 weapons (38 handguns and 29 rifles). They also seized 22 pounds of methamphetamine, 1.5 pounds of heroin and three pounds of cocaine.

Over the past three months, a federal grand jury in Orange County has returned 26 indictments that charge a total of 86 defendants. The indictments allege a wide range of criminal conduct, including murder and assault, extortion and “tax” collection, and the street-level distribution of narcotics.

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SANTA ANA – Over 800 law enforcement personnel from Orange County, Federal Bureau of Investigation (FBI), Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF), and the U.S. Marshals Service arrested dozens of dangerous, indicted gang defendants throughout Orange, Riverside, and Los Angeles Counties as part of “Operation Smokin’ Aces.”  Approximately 70 locations were included during this morning’s operations. A total of 129 individuals are being indicted either federally or at the state level at the request of the Orange County District Attorney (OCDA), at the conclusion of a two and a half year investigation. Charges include: Federal racketeering, conspiracy to commit murder, extortion, narcotic trafficking, and gun trafficking.

The Orange County Superior Court has unsealed an indictment on 43 defendants for their participation in assaults and an attempted murder on 12 inmates in the Orange County jail at the direction of a Hispanic California prison gang (Prison Gang). The OCDA presented a case to the Grand Jury for seven days involving 38 witnesses. The case against the 43 defendants is the largest state Grand Jury case in Orange County history. Three additional defendants have been charged in a separate but related case for murder.

Operation Smokin’ Aces Investigation

The Santa Ana Gang Task Force (SAGTF) comprised of members from the FBI, Santa Ana Police Department (SAPD), Orange County Sheriff’s Department (OCSD), Bureau of Alcohol, Tobacco, Firearms, and Explosives and California Department of Corrections and Rehabilitation, initiated an investigation in May 2010. The focus was a neighborhood in the southeast portion of Santa Ana that was being plagued with gang crime that included gang related shootings and narcotic sales. The scope of the investigation widened after the local gangs were tied to associates of the Prison Gang and their narcotic suppliers.

The SAGTF conducted over 140 undercover operations and seized 67 firearms, 22 pounds of methamphetamine, one and a half pounds of heroin, and three pounds of cocaine during the course of the investigation. Five of the firearms seized were linked to drive-by/walk-up shootings in the southeast portion of Santa Ana.

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