California doctor indicted for billing $45 million in bogus Botox injections to Medicare

LOS ANGELES (CN) — Prosecutors are accusing a Southern California doctor of filing $45 million in false and fraudulent claims to Medicare for Botox injections that were either medically unnecessary or never provided at all.

Violetta Mailyan, 45, is also charged with obstructing the criminal investigation of her purported fraud scheme by submitting falsified medical records in response to a grand jury subpoena, the U.S. Justice Department announced Thursday.

According to the superseding indictment filed in Los Angeles federal court, Medicare paid Mailyan $33 million of the fraudulent claims, which she used to buy luxury goods and real estate.

The government claims that Mailyan, who owned and operated the Healthy Way Medical Center in Glendale, California, billed Medicare for injections on dates when she was traveling abroad, on dates when the Medicare beneficiaries who supposedly received the services were traveling themselves or in federal prison, as well as on dates when her clinic was closed.

As part of their criminal case, prosecutors are seeking forfeiture of six properties Mailyan owns in Glendale and in Surfside, California, as well as her Tesla Model X and Tesla Cybertruck, and at least hundreds of thousands of dollars in various bank and brokerage accounts.

An attorney for Mailyan didn’t immediately respond to a request for comment. She pleaded not guilty to the original indictment in October that didn’t include the obstruction charges.

While Botox, or botulinum toxin, is popularly known for its widespread cosmetic use to reduce wrinkles, it has a number of medical uses, including to treat spasticity or excessive muscular contractions, that can be covered by Medicare Part B.

But for Botox injections to be covered, the provider is required to establish first that the patient has been unresponsive to conventional treatments such as medication or physical therapy.

There are some medical conditions, including focal dystonia, where Botox can used as the initial therapy, and in these cases providers don’t need to show that other forms treatment were unsuccessful. However, the provider has to include details in the patient’s medical record to fully support the medical necessity for Botox injections.

In addition, Medicare Part B will provide coverage for Botox injections to treat chronic migraines, defined as 15 or more days per month with a headache lasting four hours a day or longer.

The government accuses of Mailyan of fabricating patients’ medical records to make it appear that they suffered from chronic migraines when in fact they didn’t.

She faces nine counts of wire fraud and three counts of obstructing a criminal investigation of health care offenses. If convicted, she can be sentenced to as much as 20 years in prison on each wire fraud count and five years in prison on each obstruction count.

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