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January 25, 2013

San Fernando Valley Doctor Pleads Guilty in Multi-Million Dollar Medicare Fraud Case Involving Treatments Never Performed

Filed under: California Defense Attorney — Tags: , , , — fayarfa @ 5:32 am

LOS ANGELES – A medical doctor who owns a clinic in the Winnetka district of the San Fernando Valley pleaded guilty today to federal fraud charges for bilking Medicare out of more than $3 million by submitting bills for procedures never performed, sometimes involving patients he never met.

Pezhman Ebrahimzadeh, who uses the name “Pez Abrahams,” 50, of Calabasas, pleaded guilty today to one count of health care fraud before United States District Judge George H. Wu.

Ebrahimzadeh owns the Winnetka Medical Group, a cosmetic health care clinic that operates under the name Health & Beauty Clinic. At his clinic, Ebrahimzadeh provides cosmetic treatments that involve radiofrequency lasers and liposuction. As some of his patients were Medicare beneficiaries, Ebrahimzadeh obtained their beneficiary information, which was used to bill Medicare for procedures he did not perform. Ebrahimzadeh also obtained beneficiary information for patients he never treated, and he used that information to submit other fraudulent bills to Medicare.

In relation to the bogus bills submitted to Medicare, Ebrahimzadeh typically claimed he had performed three expensive procedures: revascularization, ablation of a bone tumor, or the placement of a radiotherapy catheter in a breast. Ebrahimzadeh made these claims, even though he lacked the equipment needed to perform revascularizations or the placement of radiotherapy catheters. On at least one occasion, Ebrahimzadeh admitted in court today, he billed Medicare for performing these procedures, even though the purported patient was dead.

Between September 2008 and April 2012, Ebrahimzadeh submitted $7.5 million in bogus claims, and Medicare paid just over $3 million.

Judge Wu is scheduled to sentence Ebrahimzadeh on May 20. At sentencing, Ebrahimzadeh faces a statutory maximum penalty of 10 years in federal prison. The plea agreement contemplates a sentence of approximately four to five years, but Judge Wu will make the final determination as to the actual sentence that will be imposed in this case. In the plea agreement, Ebrahimzadeh agreed to repay the millions of dollars he stole from Medicare.

December 18, 2012

Orange County Doctor Sentenced to Year in Prison in $11 Million Medicare Scam Involving Patients Recruited from L.A.’s ‘Skid Row’

Filed under: California Defense Attorney — Tags: , , — fayarfa @ 7:09 pm

LOS ANGELES – A physician who admitted homeless patients to the Tustin Hospital and Medical Center after they had been driven from “Skid Row” in downtown Los Angeles as part of a Medicare fraud scheme has been sentenced to one year in federal prison.

Dr. Kenneth Thaler, 61, of Westminster, was sentenced yesterday afternoon by Chief United States District Judge George H. King. Thaler, who admitted approximately 60 patients per month – including some who did not require hospitalization – also was ordered to pay approximately $11 million in restitution to the Medicare program.

Thaler admitted patients who had been recruited by marketers who were being paid kickbacks by Tustin Hospital. These patients had been driven from Skid Row, past various hospitals, to be admitted to the facility in Tustin.

When he pleaded guilty in 2010, Thaler admitted that he was aware that the hospital was paying illegal kickbacks to recruiters such as Estill Mitts to refer homeless Medicare and Medi-Cal beneficiaries for in-patient hospital stays. After Thaler admitted these patients, he and the hospital billed Medicare and Medi-Cal for in-patient services, even if it was not medically necessary for the patient to be hospitalized. In fact, Thaler conceded that many of the recruited patients had been coached to recite false symptoms, and that Thaler sometimes falsified medical records to justify their admission.

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December 14, 2012

Hancock Park Physician Sentenced to Year in Federal Prison in Kickback Scheme that Defrauded Medicare Program

Filed under: California Defense Attorney — Tags: , , — fayarfa @ 8:26 pm

LOS ANGELES – A Los Angeles physician who received approximately $30,000 in illegal kickbacks as part of a scheme that defrauded Medicare out of more than $5 million has been sentenced to one year and one day in federal prison.

Whan Sil Kim, also known as “Victoria Kim,” a 69-year-old Hancock Park resident, was sentenced yesterday afternoon by United States District Court Judge Dean D. Pregerson. In addition to the prison term, which Kim was ordered to begin serving by February 13, 2013, Judge Pregerson ordered the defendant to pay $1.088 million in restitution to Medicare.

Kim pleaded guilty in July 2012 to receiving illegal remunerations related to health care referrals, admitting that she fraudulently referred Medicare beneficiaries to Greatcare Home Health, Inc. in return for kickbacks. Between May 2008 and early 2011, Kim had an arrangement under which she would see – but not examine – Medicare beneficiaries at Greatcare’s clinic in the Westlake District of Los Angeles. After meeting with the Medicare beneficiaries after GreatCare’s normal business hours, Kim wrote referrals for home health services. Kim received $100 for each referral. As a part of the scheme, Kim also signed off on plans of care for the beneficiaries, falsely representing that the patients were under her care, confined to the home without a willing caregiver, and had a medical necessity for home health services. The scheme targeted elderly, primarily Korean, Medicare beneficiaries.

All of Kim’s referrals went to GreatCare and ultimately led to $1.088 million in losses to Medicare on the fraudulent claims. In total, Kim’s referrals and referrals from other doctors to Greatcare resulted in more than $5 million in losses to Medicare.

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November 27, 2012

LOS ANGELES-AREA DOCTOR PLEADS GUILTY TO CONSPIRING TO DEFRAUD MEDICARE OF OVER $11 MILLION

Filed under: California Defense Attorney — Tags: , , , — fayarfa @ 7:32 pm

WASHINGTON— A Los Angeles-area doctor pleaded guilty today to conspiring to defraud Medicare of over $11 million, announced Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney André Birotte Jr. of the Central District of California; Glenn R. Ferry, Special Agent in Charge for the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG); Bill L. Lewis, Assistant Director in Charge of the FBI’s Los Angeles Field Office; and Tony Sidley, Assistant Chief of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse.

Dr. Juan Tomas Van Putten, 66, of Ladera Heights, Calif., pleaded guilty today before U.S. District Judge George Wu in the Central District of California to one count of conspiracy to commit health care fraud.

Van Putten pleaded guilty to obtaining patients for his medical clinic, Greater South Bay Medical Group, which was located in Carson, Calif., and a nursing home where he also saw patients from street-level patient recruiters or “marketers” who illegally solicited patients with Medicare benefits for expensive, highly-specialized power wheelchairs and other durable medical equipment (DME) that the patients did not need.  According to the indictment to which Van Putten pleaded guilty, some of the marketers worked for the operators of fraudulent DME supply companies, including Van Putten’s co-defendants Charles Agbu, a church pastor, and his daughter Obiageli Agbu, who both operated Bonfee Inc. d/b/a “Bonfee Medical Supplies” and Ibon Inc., which were located in Carson.

Van Putten admitted that operators of fraudulent DME supply companies paid him cash kickbacks to write prescriptions for power wheelchairs and other DME that Van Putten knew the patients did not need.  Van Putten admitted that he exaggerated the symptoms and diagnoses that he wrote on the prescriptions to make it appear as if the patients met both the medical and Medicare requirements for the power wheelchairs and DME.  Van Putten admitted that he knew when he provided the prescriptions to the DME company operators that they would use the prescriptions to submit false claims to Medicare.  Van Putten also admitted that he submitted claims to Medicare for services that he provided to the patients at Greater South Bay and the nursing home even though he knew it was illegal for him to provide services to patients who had been recruited by marketers.

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October 22, 2012

Grand Jury Indicts New Defendants and Brings Additional Charges Against L.A.-Based OxyContin Ring that Allegedly Bilked Medicare

Filed under: Los Angeles Criminal attorney — Tags: , , — fayarfa @ 5:28 pm

Indictment Alleges that Medicare and Medi-Cal Were Fraudulently Billed for More Than $8.9 Million for the Addictive Painkiller and Unneeded Medical Services

LOS ANGELES – A federal grand jury has returned a superseding indictment that charges 16 defendants with being part of a drug trafficking organization that illegally obtained and distributed more than 900,000 OxyContin pills obtained in part through fraud against public insurance programs such as Medicare.

One of the defendants – Theodore Yoon, 68, of Arcadia – was arraigned on the new indictment this afternoon in United States District Court in Los Angeles. Nine of the defendants were arraigned yesterday. Five other defendants were arraigned October 5. The 15 defendants who have been arraigned have all pleaded not guilty and were ordered to stand trial next month. One defendant is a fugitive.

The first superseding indictment replaces charges filed a year ago, adding new charges of money laundering and structuring of cash transactions. The superseding indictment adds new defendants, including four pharmacists. The indictment alleges a conspiracy to distribute controlled substances, a conspiracy to commit health care fraud, structuring financial transactions and money laundering. The indictment also seeks the forfeiture of proceeds related to the criminal offenses.
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October 5, 2012

Eighteen Los Angeles-Area Residents Charged as Part of Nationwide Medicare Fraud Strike Force Takedown

Filed under: California Defense Attorney — Tags: , , , — fayarfa @ 7:32 pm

91 Defendants Charged in Seven Cities Linked to about $430 Million in False Billing

LOS ANGELES – Eighteen Los Angeles-area residents – including three doctors and  one physical therapist – have been charged in six local cases for their roles in schemes to submit more than $65 million in false billing to Medicare.

The charges in Los Angeles are part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that led to charges against 91 individuals for their alleged participation in schemes to collectively submit nearly $430 million in fraudulent claims to Medicare. The more than $65 million in fraudulent billing from the Los Angeles cases is believed to be the highest amount of false Medicare billing in a single Los Angeles takedown in Strike Force history.

“Medicare fraud is a national problem that has a very local dimension, impacting patients, health care providers and taxpayers in every part of the nation,” said United States Attorney André Birotte Jr. “Here in Southern California, we will continue to work with our federal, state and local partners to crack down on the unscrupulous profiteers who threaten the integrity of our health care industry, as well as the well-being of its patients and practitioners.”

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September 20, 2012

Los Angeles Physician Assistant Sentenced to 72 Months in Prison for Role in $18.9 Million Medicare Fraud Scheme

Filed under: Federal Crimes Defense Attorney — Tags: , — fayarfa @ 8:01 pm

WASHINGTON—A Los Angeles physician assistant who stole the identities of doctors to write medically unnecessary prescriptions for expensive durable medical equipment (DME) and diagnostic tests was sentenced today to serve 72 months in prison in connection with a $18.9 million Medicare fraud scheme, announced the Department of Justice, FBI and U.S. Department Health and Human Services (HHS).

David James Garrison, 50, was sentenced by U.S. District Judge Consuelo B. Marshall in the Central District of California. In addition to his prison term, Garrison was sentenced to three years of supervised release and ordered to pay $24,935 in restitution, jointly and severally with convicted co-defendants.

In June 2012, after a two-week trial, a federal jury found Garrison guilty of one count of conspiracy to commit health care fraud, six counts of health care fraud, and one count of aggravated identity theft. The trial evidence showed that Garrison worked at fraudulent medical clinics that operated as prescriptions mills and trafficked in fraudulent prescriptions and orders for medically unnecessary DME and diagnostic tests that were used by fraudulent DME supply companies and medical testing facilities to defraud Medicare. Garrison wrote the prescriptions and ordered the tests on behalf of doctors whom he never met and who did not authorize him to write prescriptions and order tests on their behalf.

The trial evidence showed that between March 2007 and September 2008, Garrison’s co-conspirator Edward Aslanyan and others owned and operated several Los Angeles medical clinics established for the sole purpose of defrauding Medicare. Aslanyan and others hired street-level patient recruiters to find Medicare beneficiaries willing to provide the recruiters with their Medicare billing information in exchange for expensive, high-end power wheelchairs and other DME, which the patient recruiters told the beneficiaries they would receive for free. Often, the solicited Medicare beneficiaries did not have a legitimate medical need for the power wheelchairs and equipment. The patient recruiters then provided the beneficiaries’ Medicare billing information to Aslanyan and others or brought the beneficiaries to the fraudulent medical clinics. In exchange for recruiting the Medicare beneficiaries, Aslanyan and others paid the recruiters a cash kickback for every beneficiary they recruited.

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September 17, 2012

Los Angeles Doctor Convicted of Health Care Fraud for Submitting to Medicare About $1 Million in Bills for Tests Never Performed

Filed under: Los Angeles Criminal attorney — Tags: , , — fayarfa @ 6:17 pm

LOS ANGELES – A doctor already serving a lengthy prison sentence in a narcotics case has been convicted of health care fraud for submitting approximately $1 million in fraudulent bills to Medicare in just seven months.

After less than a day of deliberations, a federal jury on Monday afternoon convicted Dr. Owusu Ananeh Firempong of five counts of health care fraud.

Firempong, 61, who resided in the Crenshaw district of Los Angeles and had been practicing in the Los Angeles region for more than three decades, submitted fraudulent bills for nerve conduction tests and sleep studies that were never performed.  As a result of the fraudulent bills, Medicare paid him nearly $700,000.

During a four-day trial in United States District Court, prosecutors presented evidence that Firempong obtained information about Medicare beneficiaries who were not his patients and then used that information to bill Medicare.

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August 30, 2012

Pacific Health Corporation and Three of Its Southland Hospitals Agree to Pay $16.5 Million in Cases Stemming from Illegal Kickback Scheme

Filed under: Los Angeles Criminal attorney — Tags: — fayarfa @ 5:55 pm

Marketers Were Paid to Recruit Homeless from L.A.’s ‘Skid Row’ To Undergo Often Unnecessary Treatments that Were Billed to Medicare and Medi-Cal

LOS ANGELES – A Los Angeles-based hospital chain has agreed to pay $16.5 million to resolve allegations that several of its subsidiary hospitals participated in an illegal kickback scheme in which so-called marketers were paid to recruit homeless persons from locations such as downtown Los Angeles’ “Skid Row” and bring them to Southland hospitals regardless of medical necessity, which allowed the hospitals to improperly submit bills to Medicare and Medi-Cal.

A global resolution of civil and criminal investigations conducted by the United States and the State of California was announced today when federal prosecutors filed a criminal case against Los Angeles Doctor’s Hospital, Inc. (LADH), which has agreed to plead guilty to conspiring to defraud Medicare and Medi-Cal through the payment of illegal kickbacks to the marketers.

“To root out and deter those who seek to exploit publicly funded health care programs, we need to pursue all available remedies – civil, criminal, and administrative,” said United States Attorney André Birotte Jr. “The guilty plea, civil settlement agreement, and corporate compliance agreement that we are announcing today – the result of efforts of civil and criminal attorneys in my office and officials at the Department of Health and Human Services – reflect this approach and should remind unscrupulous health care providers of our determination to bring to justice those who exploit federal and state public health programs for their personal gain.”

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June 7, 2012

Los Angeles Physician Assistant Found Guilty in $18.9 Million Medicare Fraud Scheme

Filed under: Uncategorized — Tags: , , — fayarfa @ 12:43 pm

LOS ANGELES – A physician assistant who worked at fraudulent medical clinics where he used the stolen identities of doctors to write prescriptions for medically-unnecessary durable medical equipment (DME) and diagnostic tests has been convicted of conspiracy, health care fraud and aggravated identity theft charges in connection with a $18.9 million Medicare fraud scheme.

After a two-week trial in federal court in Los Angeles, a jury on Friday afternoon found David James Garrison, 50, of Leimert Park, guilty of one count of conspiracy to commit health care fraud, six counts of health care fraud and one count of aggravated identity theft.

The evidence at trial showed that Garrison worked at fraudulent medical clinics that operated as prescriptions mills and trafficked in fraudulent prescriptions and orders for medically-unnecessary DME, such as power wheelchairs, and diagnostic tests. The fraudulent prescriptions and orders were used by fraudulent DME supply companies and medical testing facilities to defraud Medicare. Garrison wrote the prescriptions and ordered the tests on behalf of  some doctors he never met and who did not authorize him to write prescriptions and order tests on their behalf.

The trial evidence showed that between March 2007 and September 2008, Garrison’s co-conspirator, Edward Aslanyan, and others owned and operated several Los Angeles medical clinics established for the sole purpose of defrauding Medicare.  Aslanyan and others hired street-level recruiters to find Medicare beneficiaries willing to provide the recruiters with their Medicare billing information in exchange for high-end power wheelchairs and other DME, which the patient recruiters told the beneficiaries they would receive for free.  Often, the Medicare beneficiaries did not have a legitimate medical need for the power wheelchairs and equipment.  The patient recruiters provided the beneficiaries’ Medicare billing information to Aslanyan and others, or they brought the beneficiaries to the fraudulent medical clinics.  In exchange for recruiting the Medicare beneficiaries, Aslanyan and others paid the recruiters cash kickbacks.

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