US Justice Department investigating $20 million healthcare fraud

The US Justice Department is busy investigating the $20 million health care fraud which involves an ex-investigator of Anthem Cross, a physician, and three others.

On Tuesday, five people including a physician named Roshanak Khadem and a former investigator for Anthem Blue Cross, a health insurance company named Gary Jizmejian were charged by the US Justice Department for $20 million health fraud.

The names of the other two defendants are Marina Sarkisyan who is the office manager at the clinics, and Lucine Ilangezyan who worked at Anthem and is the biller for all insurances for the clinics.

It has been stated that these individuals were involved in submitting false health claims to various insurers.

As per the charges, these health claims were submitted for procedures that are not covered by the insurers. For example, cases like laser hair removal, facials, and Botox injections. Of this $20 million, $8 million was approved and paid by the insurers to these individuals. These claims were submitted at Anthem and several other insurance companies.

Gary who was the former senior investigator at the Anthem is alleged for compromising the insurance billing codes which are supposed to be confidential to Roshanak Khadem, the physician, and owner of two clinics in California.

Gary shared the billing code in return for the cash. The Anthem Blue Cross is making every effort to help the US Department of Justice for getting into the depth of the matter.

The other insurance companies that were scammed by the clinic are the Federal Employees Health Benefits Program, Warehouse Union and the Pacific Maritime Association Benefit Plan and the International Longshore.

The charges are filed for one count of conspiracy for committing health care fraud and 13 counts of health care fraud. Each of these counts can lead to a maximum of 10 years of imprisonment.

Leave a Reply

Your email address will not be published. Required fields are marked *