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Authorities Uncover $20 Million Health Care Scheme in California Federal authorities arrested five individuals connected to San Fernando Valley clinics and a significant health care fraud scheme. On May 22, a federal grand jury indictment was unsealed. The indictment alleges that the five individuals engaged in a health care fraud conspiracy over multiple years and targeted at least eight health insurance companies and the International Longshore and Warehouse Union, the Pacific Maritime Association Benefit Plan, and the Federal Employees Health Benefits Program. The Conspirators According to the Department of Justice (DOJ) press release, the co-conspirators included: Roshanak “Roxanne” or “Roxy” Khadem, 50: Khadem owned and operated two clinics, R&R Med Spa and Nu-Me Aesthetic and Anti-Aging Center. Dr. Roberto Mariano, 59: Mariano helped operate the clinics. Marina Sarkisyan, 49: Sarkisyan was a clinic office manager. Lucine Ilangezyan, 38: Ilangezyan was an insurance biller for the clinics. Gary Jizmejian, 44: Jizmejian was previously a senior investigator at the Anthem Special Investigations Unit, the insurer’s anti-fraud unit. The Allegations The indictment alleges that the co-conspirators induced patients to visit the clinics for free cosmetic procedures, such as Botox injections, facials, and laser hair removal. These procedures were not covered by insurance. The co-conspirators would gain the patients’ insurance information and bill their insurers for medical services that were unnecessary or never provided. The defendants then used some of the illegally obtained proceeds to calculate a “credit” the patients could use for discounted or free cosmetic procedures. The defendants submitted at least $20 million in insurance claims and were paid approximately $8 million. The indictment also states that Jizmejian, for cash payments, would provide Khadem and others with confidential Anthem information. This information helped the defendants submit fr
30 May 2018, 5:43 am by Gregory J. Brod
Gary Jizmejian, 44: Jizmejian was previously a senior investigator at the Anthem Special Investigations Unit, the insurer’s anti-fraud unit. [read post]
21 Mar 2013, 9:09 am by Rahul Bhagnari, ACLU
Even for workers whose employers extend coverage to same-sex spouses or who can afford to purchase private insurance, DOMA forces many LBGT workers to pay taxes on these benefits while their co-workers receive spousal healthcare coverage tax-free. [read post]
4 Jun 2019, 6:00 am
Unfortunate;y for the carrier, however, the "notable exception" had already successfully lobbied to make that move a lot more difficult:"Louisiana Insurance Commissioner Issues Cease and Desist Order to United HealthCare. [read post]
10 Jul 2018, 12:11 pm by Benjamin Wallfisch (US)
The operation also involved the participation of 30 State Medicaid Fraud Control Units and other various federal law enforcement agencies. [read post]
22 Dec 2009, 6:00 am
Latinos United for Healthcare (LUH) is a nonpartisan coalition of national, state and local Hispanic leaders and organizations that support the passage of significant healthcare reform that increases access to affordable, quality health coverage for all. [read post]
15 Nov 2017, 11:37 am by Law Offices of Ralph Behr
Borgesano is 45 and his sentencing will be scheduled in federal court before United States District Judge James S. [read post]
15 Feb 2011, 8:22 am by Mark S. Humphreys
" What is important for the consumer to know here is that such sites have become the latest tools in detecting fraud, which the insurance industry says costs the United States as much as $80 billion a year and accouts for 3% to 10% of total annual healthcare spending. [read post]
17 Nov 2011, 6:35 pm by Robert Elliott, J.D.
District Court in Raleigh against United Insurance Co. of America, according to EEOC attorney Lynette Barnes. [read post]
2 Sep 2008, 12:24 pm
 45 states prohibit this type of balance billing beyond the what are commonly known as small co-payments or co-insurance payments. [read post]
15 Nov 2017, 11:37 am by Law Offices of Ralph Behr
Borgesano is 45 and his sentencing will be scheduled in federal court before United States District Judge James S. [read post]
25 Jul 2011, 11:17 am by Law Lady
New York Attorney General Eric Schneiderman sent subpoenas in June to units of AXA SA, Genworth Financial Inc., Guardian Life Insurance Co. of America, Manulife Financial Corp., Massachusetts Mutual Life Insurance Co., MetLife Inc., etc.Title Insurance: CALIFORNIA FEDERAL JUDGE ORDERS ARBITRATION IN TITLE INSURANCE DISPUTE, In re Cal. [read post]
27 Sep 2011, 6:40 pm
If you're a United HealthCare insured and you've had any lab work done the past few years, then you're probably familiar with LabCorp. [read post]