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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
The co-conspirators would gain the patients’ insurance information and bill their insurers for medical services that were unnecessary or never provided. [read post]
11 Apr 2008, 10:57 am
This time, I turn to his decision from Wednesday in Federal Insurance Co. v. [read post]
22 Mar 2016, 7:43 am by Patrick Bracher
In Viking InShore Fishing vs Mutual & Federal Co Ltd (41/205) [2015] ZASCA 21 (18 March 2016) the court found that the insurer was liable to pay the claim relating to the sinking of a vessel that happened on 8 May 2005. [read post]
12 Feb 2007, 10:00 am
First federal trial in La. for a Katrina insurance suit 2/11/2007 By MICHAEL KUNZELMAN The Associated Press NEW ORLEANS (AP) — Jury selection is set to start Monday in the first trial for one of the several thousand lawsuits that Louisiana homeowners filed against their insurers in federal court after Hurricane Katrina. [read post]
9 Nov 2011, 6:50 am
  The Committee serves as an advisory council to the Federal Insurance Office (“FIO”) and is discussed in more detail in our blog post (here). [read post]
12 Apr 2012, 1:52 pm by Goldberg Segalla LLP
March 30, 2012) On March 20, 2012 a federal judge in Minnesota dismissed a breach of contract action brought by Olympus Insurance Co. [read post]
15 Sep 2014, 4:49 am by Matthew L.M. Fletcher
Here is the petition: Cert Petn Question presented: Whether an insurance company doing business with a federally recognized American Indian Tribe is entitled to sovereign immunity for the acts and omission it takes in furtherance of the business of insurance. [read post]