California Physician Fraud: When Will They Ever Learn? Not Any Time Soon

(What follows is an update of a story we originally published 2 years ago this month):

medi-fraud-artDoctor Emilio Louis Cruz, age 61 of Carson California, was sentenced by United States District Judge Morrison England to 3 years in prison. He was also ordered to pay $600,000 in restitution, for his role in a Medicare Fraud Conspiracy. This, according to U.S. Attorney Benjamin B. Wagner.

Court records show that Cruz, a neurology specialist, acquired his medical degree at Yale University. He held medical licenses in 3 states. According to his testimony at the trial of Cruz’s co-defendants – Doctors Ramanathan Prakash, Alexander Popov, and Lana LeChabrier – a man named Vardges Egiazarian owned 3 health care clinics in Sacramento, Richmond, and Carmichael California. Cruz operated the Carmichael clinic. He established a Medicare provider number for the clinic and set up a bank account into which Medicare funds were deposited. Hundreds of medical bills were submitted to Medicare seeking reimbursement for services. The FBI found this extremely interesting, since Cruz never treated a single patient.

During most of the time that the Carmichael clinic operated, Cruz was living and working in North Dakota. A similar pattern was followed at the other two clinics operated by Egiazarian, and not one of the physicians submitting bills to Medicare ever treated a single patient.

The clinics’ patients were primarily Hispanic who spoke no English. They were recruited and transported to the clinics by van drivers who were paid according to the number of patients they brought in. Rather than being charged a co-payment, the patients were paid for their time – generally $100 per visit – in exchange for their Medicare number. Fake medical charts were created, stating that each patient received comprehensive exams and a broad array of diagnostic tests. Few of these tests were ever performed, and none were performed based on any medical need. Clinic staff filled out other portions of the charts using imaginary information. Some clinic employees admitted to performing various tests on themselves, and placing the results into patient files.

In all, the 3 clinics billed more than $5,000,000 in fraudulent claims to Medicare – $1,700,000 of which was actually paid. With respect to claims submitted for services by Cruz at the Carmichael clinic, Medicare paid $601,581 based upon fake billing by him.

Doctors Prakash, Popov, and LeChabrier, were also found guilty by a jury on July 8, 2011, of Conspiracy to Commit Healthcare Fraud and various other charges of Healthcare Fraud.

Here is a list of those involved in this massive medical system theft case:

  • Doctor Ramanathan Prakash – currently serving 10 years in federal prison
  • Doctor Lana LeChabrier – currently serving 6 years in prison
  • Doctor Alexander Popov – currently serving 8 years
  • Doctor Derrick Johnson – pleaded guilty and is awaiting sentencing
  • Nazaret Salmanyan, an unlicensed ultrasound technician – sentenced to 20 months
  • Zoya Belov, a nurse licensed in Russia but not here – pleaded guilty and is awaiting sentencing
  • Jenny Saechao, recruited patients, pleaded guilty, and is awaiting sentencing
  • Migran Petrosyan, a co-owner of the Richmond clinic –pleaded guilty and was sentenced to 27 months
  • Shushanik Martirosyan, a medical biller who submitted fake claims to Medicare for all 3 clinics – pleaded guilty and was sentenced to 18 months

Incidentally, all of the above felons except one are criminal immigrants.

Here’s another look:

https://archives.fbi.gov/archives/sacramento/press-releases/2012/physician-sentenced-to-eight-years-in-federal-prison-for-role-in-massive-medicare-fraud-scam

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