LOS ANGELES (CN) - Two Southern California men were arrested Wednesday on the suspicion of filing more than $250 million in fraudulent medical bills connected to the 1-800-GET-THIN Lap-Band surgery business.
Federal prosecutors said the two men were indicted on the suspicion of mail fraud, wire fraud, false statements, money laundering and aggravated identity theft.
Julian Omidi, 49, of West Hollywood and Mirali Zarrabi, 55, of Beverly Hills, are accused of a scheme involving the GET THIN’s Lap-Band surgery and sleep study programs from May 2010 to March 2016, according to the Department of Justice in an indictment unsealed on Wednesday.
According to court documents, Omidi used falsified sleep studies to support his organization’s request for insurance money, which the indictment alleges 1-800-GET-THIN received at least $38 million for the insurance approved Lap-Band procedures.
Omidi’s medical license was revoked in 2009, but two corporations he controlled, Surgery Center Management, LCC and Independent Medical Services, Inc were named in the 37-count superseding indictment.
His businesses encouraged patients to get Lap-Band weight-loss surgeries and employees at the businesses were given commissions when they convinced patients to agree to sleep studies, even though Omidi knew those were not covered by insurance plans, said the indictment.
Insurance programs that fell victim to the scheme included TriCare, Anthem Blue Cross, UnitedHealthcare, Aetna and Cigna.
Through falsified sleep studies, employees would add conditions like sleep apnea, so the corporation could convince the patient’s insurance company to pre-approve surgeries. According to the indictment, these studies were not determined necessary by a doctor and results were exaggerated to make patients think they suffered from severe daytime sleepiness.
Zarrabi’s hand in the scheme involved his electronic signature being used by the 1-800-GET-THIN corporation to make it appear that he, a medical doctor, reviewed and interpreted the studies, even though he was aware they were being altered by staff.
According to court records, Zarrabi also demanded to be paid for the use of his signature on hundreds of prescriptions for devices to treat sleep apnea, but he did not review any of the documents where his signature appeared. Those falsified documents were sent along with the altered sleep studies to medical providers who billed for equipment that patients often did not need, according to the indictment.
When an insurance company did not authorize the surgery, 1-800-GET-THIN would continue to submit bills for about $15,000 for each sleep study and received millions of dollars for the claims, according to the indictment.
In 2014, more than $110 million in funds and securities that were involved in the scheme were seized by the government. Prosecutors intend to seek forfeiture of those funds in the criminal case.
The two men and the unnamed corporate defendants are scheduled to be arraigned in a United States District Court in Los Angeles.
If convicted, they face 20 years in prison for each of the 31 mail fraud and wire fraud counts mentioned in the indictment.
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