Conspirators Charged with Defrauding Medicare of Millions Using El Centro Clinic
Defendants Also Charged with Obstructing Investigation
| U.S. Attorney’s OfficeJune 16, 2015 |
SAN DIEGO—United States Attorney Laura E. Duffy announced the unsealing of a 30-count indictment today against four defendants for a conspiracy to unlawfully enrich themselves with millions of dollars by submitting fraudulent claims to Medicare for tests allegedly performed at the El Centro Medical Clinic in El Centro, California (“El Centro Clinic” or “Clinic”). The announcement was made in conjunction with a nationwide Medicare Fraud Takedown executed around the country.
The indictment alleges that defendants Paul Robinson, Levon Tovmassian, Hasmik Senekerimyan, and Nazar Muradyan, conspired with Gevorg Kupelian and others to commit health care fraud and pay kickbacks for Medicare patient referrals. Kupelian—who already pleaded guilty and was sentenced in a related case (Case Number 14CR3419-BAS)—opened the El Centro Clinic and acted as its organizer and leader. He has admitted he recruited a doctor to serve as a “front” for the Clinic in order to use his Medicare billing number to submit fraudulent Medicare claims. Kupelian also admitted he recruited and paid “cappers” to find senior citizens in El Centro and convince them to go to the Clinic for a gauntlet of tests without justification or proper supervision by a physician.
The indictment alleges that Robinson, a licensed physician, acted as the nominal owner of the El Centro Clinic and that the conspirators submitted claims for the treatment of more than 1,100 Medicare beneficiaries under Robinson’s Medicare billing number between September 2012 and February 2014. The El Centro Clinic generated over $2.7 million in claims to Medicare, which resulted in payments of approximately $1.3 million to Robinson. Robinson is accused of paying 75% of the Medicare reimbursements to Kupelian. Kupelian, in turn, paid Tovmassian, Senekerimyan, Muradyan, and others for various activities and claims designed to make the Clinic appear to be a legitimate medical service provider. Robinson is also charged with obstructing a federal audit by submitting falsified and misleading medical records.
Tovmassian, the indictment alleges, was hired to pose as a Physician’s Assistant (“PA”) who saw and treated patients at the Clinic despite not having the requisite license from the State of California. Tovmassian also allegedly ordered unnecessary medical tests that were billed to Medicare under Robinson’s billing number. Additionally, Tovmassian is charged with making a false statement to one of the investigating agents.
Senekerimyan is accused of completing fraudulent allergy test order forms and falsely claiming to administer allergy tests at the El Centro Clinic. Her husband, Muradyan, is charged with falsely claiming to drive Senekerimyan from their home in North Hollywood, California to the El Centro Clinic several times a week for her to administer allergy tests when, in fact, no tests were ever performed. Senekerimyan and Muradyan are also charged with obstructing a health care crime investigation.
“Health care fraud remains a pervasive and destructive trend nationwide, cheating our nation’s taxpayers outs of millions that could be put to better use,” said U.S. Attorney Laura Duffy. “In conjunction with our colleagues nationwide, we will continue to diligently investigate and prosecute these crimes on the nation’s behalf.”
“Aggressively combating health care fraud continues to remain a top priority of the FBI,” said San Diego FBI Special Agent in Charge Eric Birnbaum. “These indictments demonstrate that utilizing senior citizens as pawns in schemes to defraud Medicare will not be tolerated. The FBI remains committed to working with our partners in order to ensure that Medicare, which provides health care to our nation’s elderly, will be there when they need it the most.”
On April 6, 2015, U.S. District Court Judge Cynthia Bashant sentenced Kupelian to 30 months’ of custody and ordered he pay restitution in the amount of $964,011. Kupelian is currently scheduled to self-surrender on July 8, 2015. The defendants will be summoned to appear before U.S. District Court Judge Cathy Ann Bencivengo for an arraignment on the indictment.
DEFENDANT Case Number: 15CR1572-CAB
Paul Robinson Age: 52 (Counts 1-20, 25-30)
Levon Tovmassian Age: 51 (Counts 1, 3-4, 8-13, 21)
Hazmik Senekerimyan Age: 46 (Counts 1, 4, 8-9, 11-12, 15-18, 22-23)
Nazar Muradyan Age: 50 (Counts 1, 24)
SUMMARY OF CHARGES Count 1: Title 18, United States Code, Sections 371 (Conspiracy to Commit Health Care Fraud and Pay Remuneration for Health Care Referrals) Maximum penalty: Five years of custody; $250,000 Fine
Counts 2-19: Title 18, United States Code, Sections 1347 (Health Care Fraud) Maximum penalty: 20 years of custody; $250,000 Fine
Count 20: Title 18, United States Code, Sections 1516 (Obstruction of Federal Audit) Maximum penalty: Five years of custody; $250,000 Fine
Count 21: Title 18, United States Code, Sections 1001 (False Statement) Maximum penalty: Five years of custody; $250,000 Fine
Counts 22-24: Title 18, United States Code, Sections 1518 (Obstructing a Health Care Crime Investigation) Maximum penalty: Five years of custody; $250,000 Fine
*The charges and allegations contained in the Indictment are merely accusations, and the defendants are considered innocent unless and until proven guilty.
This content has been reproduced from its original source.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.