Eight Los Angeles-area medical providers are among 243 people, including 46 doctors, swept up nationally in a federal investigation of Medicare fraud.
The U.S. Department of Justice (DOJ) announced the tally on Friday of arrests and indictments that had been going on for awhile. The local folks were accused of attempting to defraud Medicare of $66 million out of the total of $712 million.
Dr. Joseph R. Altamirano of East Hollywood (pdf) is charged with submitting about $33 million in fraudulent claims for physical therapy, other services and prescriptions for expensive power wheelchairs that were not medically necessary. The grand jury indictment says Altamirano and others conspired between January and May of this year to use marketers for rounding up “beneficiaries” and writing them “medically unnecessary certifications for home health services.”
Beneficiaries also received unnecessary services in clinic, including ultrasounds, foot massages and toenail trimmings. They often did not see the doctor, but received prescriptions nonetheless.
Dr. Robert A. Glazer (pdf) and four co-conspirators were indicted for allegedly following the same playbook as Altamirano between 2006 and 2014. Medicare paid Glazer $735 million, medical equipment companies $2.6 million and home care services $16.4 million based on the doctor’s activities. Glazer’s indictment dates back to January.
Not all the Californians arrested were doctors. At least one is accused of just pretending to be one. The federal complaint against Artavazd Pashyan says he stole the identity of a real doctor and had Medicare reimbursements sent to a Wells Fargo account that he opened in December 2009.
The account was frozen in June 2010, when the real doctor was alerted to its existence. Lawyers for someone purporting to be the real doctor sued Wells Fargo to free the money up, but withdrew the lawsuit in October 2010. Pashyan told the FBI he knew nothing about the fraud, but couldn’t explain his fingerprints on a notary public’s log book witnessing documents purportedly signed by the real doctor.
A non-doctor who didn’t pretend to be one, Oxana Loutseiko, was indicted along with others in an alleged conspiracy to charge Medicare for ambulance service that wasn’t necessary. Medicare paid $13.7 million on claims of $28.4 million between January 2009 and September 2013.
Susan Nimo (pdf) is accused of being a marketer who recruited Medicare patients for end-of-life hospice services delivered through Bliss Health Care Inc doing business as Bliss Hospice Care. She was paid based on the time a person spent in hospice. They did not, apparently, expire. Bliss received $7.1 million from Medicare between 2010 and 2014 and wrote checks to Nimo for $64,894.
The national sweep, conducted by the DOJ and the U.S. Department of Health and Human Services (HHS), covered 17 states. Charges included conspiracy to commit health care fraud, violations of the anti-kickback statutes, money laundering and aggravated identity theft. More than 40 people were charged with fraud related to the Medicare’s Part D prescription drug benefit program.
Attorney General Loretta Lynch called it “the largest criminal health care fraud takedown in the history of the Department of Justice.”