LOS ANGELES – A San Fernando Valley female pleaded responsible these days to federal felony costs for conspiring to defraud wellness insurance coverage providers by creating hundreds of thousands of dollars in fraudulent promises to be submitted to deliver sufferers with “free” beauty techniques, including Botox injections.
Roshanak Khadem, 54, a.k.a. “Roxanne Khadem” and “Roxy Khadem,” of Sherman Oaks, pleaded responsible to a single count of conspiracy to dedicate wellbeing treatment fraud and a person count of subscribing to a bogus earnings tax return.
In accordance to her plea settlement, Khadem owned and operated facilities that offered aesthetic products and services to shoppers, such as R&R Med Spa in Valley Village and Nu-Me Aesthetic and Anti-Ageing Middle in Woodland Hills.
From January 2012 to April 2016, Khadem caused individuals to pay a visit to her clinics to get beauty processes, such as Botox injections, facials and laser hair removal. Khadem knew these methods were being not lined by the patients’ health insurers. Khadem also knew that her workers knowledgeable some people that, if they turned in excess of their wellbeing coverage data to the Khadem-owned clinics, the sufferers could get free or discounted cosmetic procedures pursuant to a “credit” they would gain.
Wellness insurance policies info from these patients was presented to the insurance policy biller for the clinics, figuring out and intending that the information and facts would be employed to submit false and fraudulent statements to the well being insurers for health-related procedures that Khadem knew were being possibly not truly presented to the clients or ended up not medically important.
Then, dependent on the volume that the overall health insurers paid out on those untrue and fraudulent claims, Khadem and others would compute an amount, which the co-conspirators referred to as a “credit rating,” that the sufferers could use to acquire free of charge or discounted beauty methods from the clinics. Individuals individuals would then come into the clinics to get the free of charge or discounted beauty processes.
The proceeds from the health treatment fraud conspiracy ended up deposited into bank accounts that were being held in the names of medical professionals who had been affiliated with the clinics and who signed off on and caused to be submitted the bogus and fraudulent statements beneath their names.
Khadem took possession of the proceeds from the doctors’ accounts in two strategies. Very first, mainly because Khadem experienced signatory authority on the lender accounts, she was equipped to receive the resources by creating checks on the accounts. Next, she would
withdraw funds from the lender accounts employing pre-signed checks that she attained from the doctors.
From January 2012 to April 2016, Khadem and her co-conspirators submitted claims, which involved untrue and fraudulent promises for which people corporations paid out at least $1,361,200.
Prosecutors estimate the amounts compensated based on fake and fraudulent statements submitted as section of the wellbeing treatment fraud conspiracy in which Khadem participated could be as much as $7,991,406.
The plan involving the two clinics defrauded the Worldwide Longshore and Warehouse Union, Pacific Maritime Affiliation Profit Program, which is the health advantage plan that covers longshore personnel in Southern California and their dependents. Another target was the Federal Staff members Wellbeing Gains Plan, which delivers well being insurance for federal staff.
Khadem failed to report this earnings on her money tax returns for 2013, 2014 and 2015. Khadem’s underreporting of her money for these a few several years caused a whole tax reduction of $453,451.
United States District Decide Stephen V. Wilson has scheduled a June 27 sentencing hearing, at which time Khadem will deal with a statutory greatest sentence of 13 years in federal jail.
The remaining 4 defendants in this situation each individual have pleaded responsible. Lucine Ilangezyan, 42, of North Hills, pleaded responsible to just one count of conspiracy to dedicate wellness fraud, and was sentenced to 18 months in federal prison. Gary Jizmejian, 48, of Santa Clarita, a former senior investigator at the Anthem Specific Investigations Unit, the anti-fraud unit within just Anthem that is dependable for investigating health care fraud fully commited versus the insurance policy organization, pleaded responsible to applying his mobile cellphone to mail textual content messages to co-defendants as part of a this business bribery scheme– was also sentenced to 18 months in federal jail.
Dr. Roberto Mariano, 63, of Rancho Cucamonga, a health practitioner who aided run the clinics, and Marina Sarkisyan, 52, of Panorama Town, who was the business supervisor at the clinics, await sentencing.
The United States Division of Labor, Workplace of Inspector Basic the United States Division of Labor, Worker Rewards Protection Administration Inner Revenue Service-Felony Investigations, and the Place of work of Personnel Management, Office environment of Inspector General investigated this make any difference. The United States Marshals Provider presented help relating to the asset forfeiture investigation.
Assistant United States Attorneys Valerie L. Makarewicz of the Big Frauds Section and Morgan J. Cohen of the Basic Crimes Portion are prosecuting this circumstance.