San Fernando Valley Doctor Who Pled Guilty in $3 Million Medicare Fraud Case Sentenced to More Than Three Years in Federal Prison

LOS ANGELES—A medical doctor who owns a cosmetic medicine clinic in the Winnetka district of the San Fernando Valley has been sentenced to 42 months in federal prison for bilking Medicare out of more than $3 million by submitting bills for procedures he never performed.
Pezhman Ebrahimzadeh, who uses the name “Pez Abrahams,” 50, of Calabasas, received the three-and-a-half-year sentence yesterday from United States District Judge George H. Wu.
In addition to the prison term, Judge Wu ordered Ebrahimzadeh to pay $3,184,000 in restitution, most of which is to be paid to the Medicare program.
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 met or 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.
Ebrahimzadeh’s “conduct was so brazen that he billed Medicare for purportedly performing dozens of procedures on patients who were dead,” prosecutors wrote in a sentencing memorandum to the court. “For one such patient, defendant billed Medicare for seven separate high-paying procedures. [Ebrahimzadeh] also altered medical records in an attempt to conceal his fraudulent conduct. In addition to defrauding Medicare, defendant billed private insurance carriers for similar procedures, some of which he claimed he performed on himself.”
Between September 2008 and April 2012, Ebrahimzadeh submitted $7.5 million in bogus claims, and Medicare paid just over $3 million.
Ebrahimzadeh pleaded guilty in January to one count of health care fraud.
In the sentencing memo, prosecutors noted that Ebrahimzadeh was arrested last month on suspicion of sexually assaulting a patient during a physical examination.
The case against Ebrahimzadeh was investigated by the U.S. Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; and the California Department of Justice, Bureau of Medi-Cal Fraud & Elder Abuse.

Southern California Physician and Two Co-Conspirators Found Guilty for Roles in $1.5 Million Medicare Fraud Scheme

WASHINGTON—A Southern California physician, a durable medical equipment (DME) supply company employee, and a health care professional were found guilty late yesterday by a federal jury in Los Angeles for their roles in a $1.5 million Medicare fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Criminal Division; U.S. Attorney for the Central District of California André Birotte, Jr.; Bill L. Lewis, Assistant Director in Charge of the FBI’s Los Angeles Field Office; and Glenn R. Ferry, Special Agent in Charge of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).
Godwin Onyeabor, 49, of Ontario, California; Sri J. Wijegunaratne, 58, of Anaheim, California; and Heidi Morishita, 48, of Valencia, California, were each found guilty in U.S. District Court in the Central District of California of one count of conspiracy to pay and receive kickbacks. Wijegunaratne was also found guilty of conspiracy to commit health care fraud and six substantive counts of health care fraud. Onyeabor was also found guilty of conspiracy to commit health care fraud and 11 substantive counts of health care fraud.
The trial evidence showed that between January 2007 and February 2012, Onyeabor, an officer at Fendih Medical Supply Inc., a DME supply company located in San Bernadino, California, and others paid cash kickbacks to Wijegunaratne, a physician, and Morishita for fraudulent prescriptions for DME, including power wheelchairs. The evidence showed that Wijegunaratne wrote prescriptions for power wheelchairs and other DME that Medicare beneficiaries did not need and sometimes never used. After receiving prescriptions from Wijegunaratne and Morishita, Onyeabor and others used the prescriptions to fraudulently bill Medicare for the medically unnecessary DME.
At trial, several Medicare beneficiaries testified that they were lured to medical clinics with the promise of free items such as vitamins and juice, only to receive power wheelchairs that they did not need and did not want. The beneficiaries further testified that their attempts to reject delivery of the power wheelchairs from Onyeabor’s supply company were unsuccessful.
As a result of this fraud scheme, Onyeabor, Wijegunaratne, and others submitted and caused the submission of approximately $1.5 million in false and fraudulent claims to Medicare, and received almost $1 million on those claims.
At sentencing, scheduled for September 9, 2013, Onyeabor, Wijegunaratne, and Morishita face a maximum penalty of 10 years in prison and a $250,000 fine for each count.
The case is being prosecuted by Assistant Chief Benton Curtis and Trial Attorneys Fred Medick and Alexander Porter of the Criminal Division’s Fraud Section. The case was investigated by the FBI and the Los Angeles Region of HHS-OIG.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Former Owner of Los Angeles Medical Equipment Supply Company Pleads Guilty to Conspiring to Defraud Medicare

WASHINGTON—A former owner of a Los Angeles-area medical equipment supply company pleaded guilty today to conspiring with others to defraud Medicare, announced Acting Assistant Attorney General Mythili Raman 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); and Bill L. Lewis, Assistant Director in Charge of the FBI’s Los Angeles Field Office.
Tigran Aklyan, 37, of Van Nuys, California, pleaded guilty before U.S. District Judge Michael W. Fitzgerald in the Central District of California to one count of conspiracy to commit health care fraud.
According to court documents, Aklyan was the owner and president of Las Tunas Medical Equipment Inc., a durable medical equipment (DME) supply company located in San Gabriel, California. Aklyan admitted that from approximately October 2007 through May 2009, he conspired with others to commit health care fraud through the operation of Las Tunas by providing medically unnecessary power wheelchairs and other DME to Medicare beneficiaries and submitting false and fraudulent claims to Medicare. Aklyan admitted that he paid the owners and operators of fraudulent medical clinics to provide him with prescriptions and supporting medical documentation for the power wheelchairs and DME that he billed to Medicare. Aklyan admitted knowing that the prescriptions and medical documents that the clinics produced were fraudulent, yet he certified to Medicare with the submission of each claim that the DME was medically necessary. Aklyan also admitted that he knew it was illegal for him to pay for prescriptions, but he did so anyway.
From approximately December 17, 2007 through February 20, 2009, Aklyan, through Las Tunas, submitted approximately $910,377 in fraudulent claims to Medicare for power wheelchairs and related services, and Medicare paid Las Tunas approximately $653,461 on those claims.
At sentencing, scheduled for August 5, 2013, Aklyan faces a maximum penalty of 10 years in prison and a $250,000 fine.
This case is being prosecuted by Trial Attorneys David M. Maria and Blanca Quintero of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Texas Doctor Indicted for Health Care Fraud Violations

TYLER, TX—A Dallas County, Texas physician has been arrested and charged with health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.
Tariq Mahmood, 61, of Cedar Hill, Texas, was indicted by a federal grand jury on April 11, 2013, and charged with conspiracy to commit health care fraud and seven counts of health care fraud. Mahmood went before U.S. Magistrate Judge John D. Love today for an initial appearance.
According to the indictment, Mahmood, a general practitioner, owned and operated several hospitals in the state of Texas, including Cozby Germany Hospital in Grand Saline, Renaissance Terrell Hospital in Terrell, Central Texas Hospital in Cameron, Community General Hospital in Dilley, and Shelby Regional Medical Center in Center. From April 2010 to April 2013, Mahmood and others are alleged to have carried out a scheme to defraud Medicare and Medicaid through the submission of false and fraudulent claims. Mahmood and others added, changed, deleted, and incorrectly sequenced diagnostic codes in a way that did not reflect the actual diagnoses and conditions of the patients. They submitted false and fraudulent claims to Medicare and Medicaid based on the added, changed, deleted, and incorrectly sequenced diagnostic codes. By means of fraudulent billing practices, the defendant and his co-conspirators are alleged to have unlawfully submitted false claims of more than $1.1 million and obtained more than $375,000.
If convicted, Mahmood faces up to 10 years in federal prison for each charge.
The investigation leading to the charges was conducted by agents from the Texas Office of the Attorney General-Medicaid Fraud Control Unit (OAG-MFCU), the Federal Bureau of Investigation (FBI), the U.S. Department of Health and Human Services-Office of the Inspector General (HHS-OIG), and the U.S. Postal Inspection Service (USPIS). Assistant U.S. Attorney Nathaniel C. Kummerfeld is prosecuting this case.
Any individuals with knowledge of these or other health care fraud violations are encouraged to contact the Department of Health and Human Services’ fraud hotline at 1-800-HHS-TIPS (447-8477)
A grand jury indictment is not evidence of guilt. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Harrison County Man Sentenced for Dealing Meth in East Texas

MARSHALL, TX—A 56-year-old Marshall, Texas man has been sentenced to federal prison for drug trafficking violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.
Adrian Denova Sanchez pleaded guilty on January 30, 2013, to conspiracy to possess with intent to distribute and distribution of methamphetamine and was sentenced to 127 months in federal prison on April 19, 2013, by U.S. District Judge Rodney Gilstrap. Sanchez was also ordered to forfeiture of $10,000 to the U.S. Marshals Service.
According to information presented in court, between November 2009 and October 2012, Sanchez was involved in a conspiracy to manufacture and distribute methamphetamine and cocaine in East Texas. Sanchez admitted to distributing over 50 grams of methamphetamine and selling a semi-automatic pistol during the conspiracy. Sanchez and four others were indicted on November 7, 2012, and charged with federal drug and gun crimes.
This case was investigated by the Federal Bureau of Investigation, the Marshall Police Department, the Harrison County District Attorney’s Office, the Harrison County Sheriff’s Office, and the Texas Department of Public Safety-Special Crimes and was prosecuted by Assistant U.S. Attorney Allen Hurst.

Lake Charles Doctor Pleads Guilty to Health Care Fraud

LAFAYETTE, LA—United States Attorney Stephanie A. Finley announced today that Dr. Lynn E. Foret, 63, of Lake Charles, Louisiana, pleaded guilty before U.S. District Court Judge Richard T. Haik to defrauding Medicare, Medicaid, and private insurance companies of close to $1 million.
According to the bill of information, from 2003 to 2009, Foret injected his patients’ knees with a steroid solution while falsely billing and receiving payments from Medicare, Medicaid, and private insurance companies for a more costly drug called Hyalgan. During the time period outlined in the bill of information, he received reimbursements totaling $948,249.11. Foret is a Lake Charles medical doctor who specialized in orthopedic surgery since 1976. He closed his practice in December 2012.
Various types of steroids are often used to treat osteoarthritis of the knee. Hyalgan is another more costly type of medication that is used to treat osteoarthritis. It contains a natural substance called Hyaluronate, which is normally found in the fluid that lubricates and cushions knee joints and is injected directly into a patient’s knee to relieve inflammation.
Foret faces a maximum penalty of 10 years in prison, a $250,000 fine, restitution, and three years of supervised release for the count of heath care fraud. A sentencing date has not been set.
The Medicaid Fraud Control Unit (MFCU) of the Louisiana State Attorney General’s Office, FBI, U.S. Food and Drug Administration, and the Department of Health and Human Services-Office of Inspector General (OIG) conducted the investigation. Assistant U.S. Attorney Kelly P. Uebinger is prosecuting the case.

Detroit-Area Home Health Agency Office Manager Convicted in $5.8 Million Medicare Fraud Scheme

WASHINGTON—A federal jury in Detroit today convicted the office manager of a home health agency for her participation in a $5.8 million Medicare fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Robert D. Foley, III, Special Agent in Charge of the FBI Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations, Detroit Office.
Nabila Mahbub, 27, the office manager of All American Home Care Inc., was found guilty in U.S. District Court for the Eastern District of Michigan of one count of conspiracy to commit health care fraud.
Mahbub was charged in a superseding indictment returned March 27, 2012. Nineteen other individuals who worked at or were associated with All American were previously convicted for their roles in the fraudulent scheme; one was acquitted at trial but was convicted at trial for a separate, but related, scheme.
According to evidence presented at trial, the defendant and her co-conspirators caused the submission of false and fraudulent claims to Medicare through All American, a home health care company located in Oak Park, Michigan, that purported to provide skilled nursing and physical therapy services to Medicare beneficiaries in the greater Detroit area.
The evidence at trial showed that the defendant and her co-conspirators used patient recruiters, who paid Medicare beneficiaries to sign blank documents for physical therapy services that were never provided and/or medically unnecessary. The owners of All American paid physicians to sign referrals and other therapy documents necessary to bill Medicare. Physical therapists and physical therapist assistants then created fake medical records using blank, pre-signed forms obtained by the patient recruiters to make it appear as if physical therapy services were actually rendered, when, in fact, they were not.
According to evidence presented at trial, Mahbub doctored and directed the doctoring of fake patient files to facilitate the commencement and billing of home health services purportedly provided by physical therapists and physical therapist assistants working for All American. Mahbub also directed the physical therapists and physical therapist assistants who created fake therapy visit notes using blank, pre-signed forms, to make it appear that physical therapy services billed to Medicare were actually provided.
All American was paid more than $5.8 million from Medicare between September 2008 and November 2009.
At sentencing, scheduled for July 25, 2013, Mahbub faces a maximum penalty of 10 years in prison.
This case is being prosecuted by Deputy Chief Gejaa T. Gobena and Trial Attorney Matthew C. Thuesen of the Criminal Division’s Fraud Section. The investigation was led by the FBI and HHS-OIG and was brought by the Medicare Fraud Strike Force, a joint effort of the U.S. Attorney’s Office for the Eastern District of Michigan and the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.