Tuesday, November 14, 2017

Non-Physician Operator of Medical Clinic in Burbank Sentenced to 37 Months for Federal Healthcare Fraud in U.S. Central District

Years ago, healthcare fraud would be prosecuted primarily if there were "ghost" billing (billing for non-existent patients or services that were never provided). That has changed significantly and billing for patients who were brought in by marketers for allegedly "medically unnecessary" services has become more common. A recent case shows how these cases are being aggressively handled at the federal level in Los Angeles.

On October 2, 2017, Knarik Vardumyan, a non-physician "owner-operator" of a Burbank medical clinic was sentenced to 37 months in federal prison on federal healthcare fraud charges for participating in a scheme to defraud Medicare by prescribing unnecessary services and equipment, which allegedly often were not even provided. The sentence was imposed by United States District Judge Dale S. Fischer. 

Judge Fischer also ordered Ms. Vardumyan to pay $1,711,789 in restitution to the Centers for Medicare & Medicaid Services. There was no trial in this case since Ms. Vardumyan pleaded guilty in April 2017 to two counts of federal healthcare fraud.

In the plea agreement, Ms. Vardumyan admitted that she knowingly and unlawfully participated in a scheme to defraud Medicare by billing Medicare for “medically unnecessary office visits and diagnostic tests,” and by arranging “for the issuance of . . . prescriptions and orders for medically unnecessary durable medical equipment” and “home health services.” This case involved billing for office visits, diagnostic tests, durable medical equipment and home health. This means that there must have been some coordination between the ancillary services and Ms. Vardumyan's clinic.

There was improper marketing since Ms. Vardumyan further admitted, “many, if not all” of the people who visited her clinic “were brought . . . by co-schemers known as ‘marketers,’ who offered promises of free, medically unnecessary [equipment] or food” to those Medicare beneficiaries who were willing to attend Vardumyan’s clinic.

Although there was a plea, the government suggested a 37 month sentence which Judge Fischer apparently agreed with in addition to the sentence suggested by Pretrial Services. The sentence suggests to me that Ms. Vardumyan was not able to repay much restitution prior to sentencing.

This was was investigated by the Federal Bureau of Investigation which has a strong healthcare fraud unit.

Posted by Tracy Green, Esq.

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