Twelve Los Angeles-Area Residents Accused of Attempting to Bilk Medicare of $22 Million Arrested as Part of Nationwide Crackdown
U.S. Attorney’s Office
LOS ANGELES—Twelve Los Angeles-area residents—including California’s second-largest biller for chiropractic services, a physician’s assistant, and owners of durable medical equipment (DME) and ambulance companies—were taken into custody today in relation to seven criminal cases that allege they cumulatively submitted more than $22 million in false billings to Medicare....
Dr. Houshang Pavehzadeh, of the Sylmar Physician Medical Group, allegedly billed Medicare more than $1.7 million for chiropractic treatments he never performed. During the scheme, which ran from 2005 through 2012, Dr. Pavehzadeh, 40, of Agoura Hills, became the second-largest Medicare biller in California for chiropractic services—even though he was not in the United States when some of the alleged services were performed. In addition to being charged with health care fraud, Pavehzadeh is charged with aggravated identity theft related to Medicare beneficiaries whose information he used to bill Medicare as a part of the scheme. When investigators tried to conduct an audit of Pavehzadeh’s claims, he falsely reported to the Los Angeles Police Department that he had been carjacked and that patient files requested by the auditors had been stolen from his car. Pavehzadeh surrendered this morning, and he is scheduled to be arraigned with other Los Angeles-area defendants this afternoon in the Roybal Federal Building.
Nine defendants affiliated with DME companies were also charged in five separate indictments.
Olufunke Fadojutimi, 41, of Carson, a registered nurse; Ayodeji Temitayo Fatunmbi, 41, formerly of Carson and now believed to be residing in Nigeria; and Maritza Velazquez, 40, of Las Vegas, were charged with health care fraud. The scheme allegedly revolved around Lutemi Medical Supplies, a DME company Fadojutimi owned and where Fatunmbi and Velazquez worked. According to the indictment in this case, Lutemi billed Medicare more than $8.3 million in claims, primarily for medically unnecessary power wheelchairs. Fadojutimi and Fatunmbi allegedly laundered Medicare funds in order to purchase fraudulent prescriptions for those power wheelchairs and pay illegal kickbacks to recruit Medicare beneficiaries. Fadojutimi was arrested this morning in Los Angeles, while Velazquez was arrested in Las Vegas. Fatunmbi is currently a fugitive being sought by federal authorities.
Susanna Artsruni, 45, of North Hollywood, and Erasmus Kotey, 76, of Montebello, a licensed physician’s assistant, allegedly worked together to commit health care fraud out of a medical clinic on Vermont Avenue where they both worked. Kotey allegedly prescribed medically unnecessary DME, including power wheelchairs, for Medicare beneficiaries. Many of those power wheelchair prescriptions were then used by Artsruni’s DME company, Midvalley Medical Supply, to support fraudulent claims to Medicare. In only four months, the clinic and Midvalley billed Medicare more than $525,000 for these fraudulent claims. Artsruni has previously been convicted of health care fraud and was on pre-trial supervision at the time she allegedly laundered some of the proceeds of this fraud. Artsruni was arrested this morning, while Kotey self-surrendered.
Three other DME cases were also charged, alleging fraudulent Medicare billing for medically unnecessary power wheelchairs that were sometimes never even delivered. In one case, Akinola Afolabi, 53, of Long Beach, the owner of Emmanuel Medical Supply, allegedly submitted more than $2.6 million in false and fraudulent billing to Medicare. In another case, Queen Anieze-Smith, 52, of Encino, and Abdul King-Garba, 47, of Westwood, the owners and operators of ITC Medical Supply, allegedly submitted more than $1.8 million in false and fraudulent billing to Medicare.
Shouldn't they have named their front operation Royal Medical Supply?
In the third case, Clement Etim Aghedo, 53, of Fontana, the owner of Ace Medical Supply Company, allegedly submitted more than $1.8 in false and fraudulent claims to Medicare. Afolabi, Anieze-Smith, and King-Garba were all arrested this morning, while Aghedo self-surrendered.
In the seventh case brought as part of today’s takedown, three defendants affiliated with Gardena-based ProMed Medical Transportation, an ambulance company, were charged with submitting more than $5.9 million in false claims to Medicare between 2008 and 2011. ProMed’s owner, Yaroslav Proshak, 45, of Valley Village; general manager Sharetta Wallace, 35, of Inglewood; and office manager and biller Sergey Mumjian, 40, of West Hollywood, submitted claims for medically unnecessary transportation services and then created fake documentation purporting to support those claims. Proshak, Wallace, and Mumjian were arrested this morning.
This press release would make the Statue of Liberty proud.
36 comments:
What a web of vibrant, diverse inclusiveness!
I'll always remember fondly the L.A. of the Adam 12 episodes.
Seems like a rather old bunch (only one under 40). I thought crime was mostly done by the young.
50 is the new 20 (I hope)
So whye xactly is diversity "strength"?
Are any of these people real doctors, i.e. MDs?
Doesn't look like it from what I see.
Why is this bullshit charged under medicare?
Sylmar Physician Medical Group
It's just a bullshit cupping, acupuncture, chiropractor business. How is this nonsense accepted under Medicare?
Aside from that the power wheelchair nonsense has always been a fraud for the American taxpayer. These guys were just too sloppy I guess.
Doing the jobs Americans won't do!
Pursuing their Dream!
I grift my scam inside the Golden Door!
Can't you just wait for Obamacare to kick in? If you think Medicare scams and hustles are bad, you ain't seen nothin' yet.
I used to work in the health care field in Los Angeles for almost 10 years and I can tell you first hand that Medicare fraud is absolutely rampant. And imagine my surprise when my own Gastro doctor was arrested in one of the largest Medicare fraud stings in California history! These people make me absolutely sick because of their criminal activity they cause health care rates for others to go up. The are scum.
Something tells me that Smith and Wallace are going to get top billing on this one.
Dr. Houshang Pavehzadeh? What is s/he, Chinese-Iranian?
oh and this is why true diversity takes both lots of money, AND a police state to survive.
Judging by the names on that list, the defendants were one Persian, seven Africans (probably six Nigerians and a Ghanaian), three Eastern Europeans (one each of Ukrainian, Armenian, and Georgian, and looking at the first names probably none of whom were born here), a Hispanic American and a White or Black American.
Persians and Eastern Europeans, particularly Russian and Armenian immigrants, are always heavily over-represented in these LA metro area medical billing scam stories. The large number of West African names on this one was surprising, though.
No, Hooshang/Houshang is a fairly common male Persian name.
Increasingly, whenever I see any member of the United States Government, whether an employee of the executive branch or an elected official, I am reminded of the words that brought down McCarthy during the Army hearings.
Have you no sense of decency, sir? At long last, have you left no sense of decency?
But no, of course not. Of course not.
There is a wider point, that the costs of immigration as a whole are in fact a fraud perpetrated on the diminishing band of productive, honest taxpayers.
These individuals are simply the tip of the iceberg, and furthermore, their apprehension by the law gives the entirely misleading impression that the government authorities are getting the problem under control, whereas in fact the reality is exactly opposite.
Anon.
Organized crime is a family affair.
Immigrant groups are ready-made to conspire to rip off the government. Crimes like these are laughably easy to pull off if you have trustworthy co-conspirators. And, of course, they're stealing money from other ethnic groups (Whites mostly), so they have no moral constraints.
Hunsdon said...
Have you no sense of decency, sir? At long last, have you left no sense of decency?
---
Decency has no place in New America.
@auntie analogue - "Can't you just wait for Obamacare to kick in? If you think Medicare scams and hustles are bad, you ain't seen nothin' yet."
oh, yeah. =/
Fish rots from the head.
If Wall Street billionaires can use finance like casino, gamble and lose, and then be 'bailed out' and grow fat during the recession--and not be prosecuted--, why should anyone else care?
It doesn't justify what these scumbags did--and they must face justice--, but are they worse than elites who rule this nation? No.
I emailed the link to Steve, thinking it would be of interest. Having worked as a lawyer in workers comp defense, you need to discern who the frauds are, and who's trying to steal money from you.
I found the only infallible way to detect someone trying to steal money from my client is to look them up on the Medical Board's website. If they went to med school somewhere between Calcutta, Cairo, and Baku, watch out.
The chiro thing is just an artifact of powerful lobbying. They donate money to legislators so the system continues to pretend they're real doctors, when in fact they have less real medical training than barbers did in the 19th Century, and less ethics than a Republican politician. Chiropractors tend to be unethical scumbags of the lowest order.
My favorite current example is compound medications. Instead of a getting one or two pills for pain (and the pills have to be prescribed by a real MD), chiropractors now provide compound medications - e.g. a smidgen of OTC tylenol in a tub filled with clay or wasabi.
This is about 5% as effective as pills, and costs around 10,000% more (not an exaggeration). Naturally, this is all the rage in Southern California. Naturally, it is allowed routinely.
The chiro thing is just an artifact of powerful lobbying. They donate money to legislators so the system continues to pretend they're real doctors, when in fact they have less real medical training than barbers did in the 19th Century, and less ethics than a Republican politician. Chiropractors tend to be unethical scumbags of the lowest order.
Hey, people swear by it.
Have you guys heard of qui tam?
You get 5-30% of the recovery to the US treasury if you can be successful in relating evidence in a fraud against the federal government.
There's one guy who has earned 20 million after returning a billion to the US gov.
Any local LA people can give me tips on how to go about collecting evidence for my own qui tam lawsuit?
Good Lord!,
A real alphabet-soup of names, pronunciations and strung-together words - of a sort that only LA or London could possibly produce. The history of hundreds of thousands of years of philogy encapsulated in one paragraph - never mind the evolutionary psychology.
Hairy men, swarthy types, carpet dealers plus yer typical Igbo bullshitter all come together with the goal of scamming Mr. Whitebread Whitey from the sweat of his brow.
Who would have thunk it?
Anonydroid at 12:40 AM said: all come together with the goal of scamming Mr. Whitebread Whitey from the sweat of his brow.
Hunsdon said: Ah, good sir, we're no longer in Hungary. Here the proper formulation is Whitey Whitebread. We place the Christian name before the family name, contra Hungarian practice.
I worked in Medicare reimbursement, doing data entry from forms submitted by so-called medical care providers seeking reimbursement for services supposedly performed.
One day, I had a huge batch of reimbursements for blood draws and blood tests from this clinic in Oregon, and we're talking hundreds, possibly thousands. And the names on the forms were super-fake, even random-sounding like a computer-generated password, and not the sorts of names you'd expect to see in this particular Oregon city. I suspected fraud.
So I brought this to the attention of a foreman/supervisor. She told me it wasn't my job to question the validity of the reimbursement forms.
I was canned about three months later. True story.
Queen Anieze-Smith
The first name Queen seems to denote a level of self-absorption in black women that well predicts crime. A few years ago in the Bay Area there was a Queen Udofia who hijacked the company credit card while working as a receptionist at an arch. firm. When fired, she sued for race discrimination.
It's just a bullshit ... acupuncture ... business. How is this nonsense accepted under Medicare?
These modality increase the brood frow.
"The chiro thing is just an artifact of powerful lobbying. They donate money to legislators so the system continues to pretend they're real doctors, when in fact they have less real medical training than barbers did in the 19th Century, and less ethics than a Republican politician. Chiropractors tend to be unethical scumbags of the lowest order."
The services of a good chiropractor is invaluable when needed. Virtually every service in LA is infested with poor quality practitioners.
Chiropractors don't need "real medical training" to do what they do. An intelligent person could become trained in about two weeks.
Getting mad at chiropractors makes about as much sense as getting mad at the lawn guy. They are both useful and serve a purpose.
if there was one low level white male involved, his mug would have been on the front page.
Definitely ticks the "wretched refuse" box.
"I'll always remember fondly the L.A. of the Adam 12 episodes."
And Dragnet!
Medicare fraud, government contracting fraud, income tax fraud - I'm beginning to think that the government is, in fact, a willing conspirator to these scams as a way to funnel more money to the diverse, vibrant, and disadvantaged.
I'd go with a physiotherapist. Chiros are quacks.
Uh oh!
A short word in defense of chiropractors.
My maternal grandfather was struck by a train walking home one evening. (Don't ask.) He endured three back operations and ten years of constant, crippling pain. He found a good chiropractor who, with regular treatments (3x weekly for five years, 1x monthly after that) restored his mobility.
My sister, in the early bloom of her womanhood, had crippling headaches. Crippling. Come home from school and lie in the dark crying for four hours before getting up and doing her homework crippling.
I myself, disregarding my exalted status as a NCO, attempted to catch a box falling out of the back of a truck. Were it not for the pilot program the DOD was running to test chiropractic care, those Navy butchers would have chopped away at my back.
There are quacks, frauds and charaltans galore in the field of chiropractics . . . as in the fields of "proper medicine," law, academia, politics and so on. A good chiropractor can work wonders.
Good posture is a tremendous help, also. The old DI's bark of "chin up, shoulders back, chest out, belly in" can act as a marvelous preventative.
Dufus maximus,
Out of public spiritedness, can you please name the blood bank? Or try to look it up?
A short word in defense of chiropractors.
I've had good luck with a couple chiropractors for certain things, mainly spinal and joint issues. But I have to admit that many of them come across as quacks or hucksters. Many are into various forms of "energy healing" that have no basis in fact and often cost more than the stuff they do that actually helps. Most of them seem to be expert marketers, too, as if chiropractic school requires that you attend classes on how to build your clientele through an aggressive campaign of newsletters and other marketing techniques.
I'm not a fan of government regulation, so I'm not calling for that. But I tell people, if you need something popped back into place and they'll do that for $50, fine; but run if they start talking about your chakras or want to schedule you for 8 weeks of bi-weekly appointments.
We cannot get enough Nigerians, but please Mr. President and Mr. Attorney General, please protect us from those dangerous German home schoolers.
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