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Blog » News » California physician pleads guilty to million-dollar healthcare fraud

California physician pleads guilty to million-dollar healthcare fraud

california-physician-pleads-guilty-to-million-dollar-healthcare-fraud

A California physician has pleaded guilty to million-dollar healthcare fraud in Los Angeles.

Lilit Gagikovna Baltaian is the person at the center of the guilty plea. Their crime, over the best of a decade, infringed on the United States Medicare program.

Baltaian was investigated by the Human Services Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation (FBI) for $1,449,050 in damages resulting from fraudulent Medicare claims.

Trial Attorneys Matthew Belz and Eric Schmale of the Justice Department’s Criminal Division Fraud Section are prosecuting the case.

Healthcare provider pleads guilty to fraud

Baltaian, of Porter Ranch, operated as a physician licensed to practice in California and an enrolled Medicare provider. The court documents alleged that from January 2012 through July 2018, Baltaian “falsely certified patients to receive home health care from at least four Los Angeles area home health agencies. Baltaian’s false certifications were used by the home health agencies to fraudulently bill Medicare for the unnecessary home health care.”

The Justice Department court admissions also stated that Baltaian “pre-signed blank, undated physician certification forms.” They provided fraudulent admissions and supporting documentation to disguise the fact that she had carried out the due diligence needed to make a Medicare beneficiary claim.

She took cash bribes and benefits due to the referrals and false admissions when submitting claims to Medicare for signing fraudulent certifications. Her sentencing will take place on April 3, 2025, and she could face up to 10 years in prison.

In a related case, Due reported that two brothers have been convicted of Medicare, Medicaid, and Private Insurer Fraud related to prescription medication claims.

Raad Kouza, a pharmacist, and Ramis Kouzza collectively caused Medicare, Medicaid, and Blue Cross Blue Shield of Michigan to lose over $15 million. Information disclosed as part of the investigation and court proceedings showed the two men based in Michigan billed Medicaid and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated in Michigan.

Image: Pexels.

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