Two Doctors Arrested- Bogus Sleep Studies Helped 1-800-GET-THIN Fraudulently Bill Insurance Programs

[nitpicker]

https://www.justice.gov/usao-cdca/pr/two-doctors-arrested-pursuant-federal-indictment-alleges-bogus-sleep-studies-helped-1

Department of Justice
U.S. Attorney’s Office
Central District of California

FOR IMMEDIATE RELEASE
Wednesday, February 28, 2018

Pursuant to Federal Indictment that Alleges Bogus Sleep Studies Helped 1-800-GET-THIN Fraudulently Bill Insurance Programs over $250 Million Related to Lap-Band Surgeries

LOS ANGELES – Two doctors were arrested this morning on federal fraud charges stemming from more than $250 million in allegedly fraudulent bills related to the 1-800-GET-THIN Lap-Band surgery business. Julian Omidi, 49, of West Hollywood, and Mirali Zarrabi, 55, of Beverly Hills, were arrested pursuant to a federal indictment that alleges a host of criminal charges stemming from GET THIN’s Lap-Band (or bariatric) surgery and sleep study programs between May 2010 and March 2016. Two corporations controlled, in part, by Omidi – Surgery Center Management, LLC (SCM), and Independent Medical Services, Inc. (IMS) – are also named in the 37-count superseding indictment that was unsealed today. The indictment contains charges of mail fraud, wire fraud, false statements, money laundering and aggravated identity theft.

Omidi, a physician whose license was revoked in 2009, controlled, in part, the GET THIN network of entities, including SCM and IMS, that focused on the promotion and performance of elective, Lap-Band weight-loss surgeries. Omidi established procedures requiring prospective Lap-Band patients – even those covered by insurance plans he knew would never cover Lap-Band surgery – to have at least one sleep study, and employees were incentivized with commissions to make sure the studies occurred, according to the indictment. The purpose of the sleep studies was to find a second reason – a “co-morbidity,” such as sleep apnea – that GET THIN would use to convince the patient’s insurance company to pre-approve the Lap-Band procedure.

After patients underwent sleep studies – often with little indication that any doctor had ever determined the study was medically necessary – GET THIN employees, acting at Omidi’s direction, allegedly often falsified the results to reflect that the patient had moderate or severe sleep apnea, and that they suffered from severe daytime sleepiness. Omidi then caused those falsified sleep study reports to be used in support of GET THIN’s pre-authorization requests for Lap-Band surgery.

Relying on the false sleep studies – as well as other false information, including patients’ heights and weights – insurance companies authorized payment for some of the proposed Lap-Band surgeries. The indictment alleges that GET THIN received at least $38 million for the Lap-Band procedures.

Even if the insurance company did not authorize the surgery, GET THIN still was able to submit bills for approximately $15,000 for each sleep study, receiving millions of dollars in payments for these claims, according to the indictment. The insurance payments were deposited into bank accounts associated with the GET THIN entities. The victim health care benefit programs include TriCare, Anthem Blue Cross, UnitedHealthcare, Aetna, Cigna and others.
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Zarrabi allowed his electronic signature to be used by GET THIN to make it falsely appear that he had reviewed and interpreted the falsified sleep studies, even though he knew the reports were being altered, according to the indictment. Zarrabi also allegedly demanded to be paid for the use of his electronic signature on hundreds of prescriptions for devices to treat sleep apnea. Zarrabi allegedly did not review the prescriptions, which were sent with the falsified sleep study reports to durable medical equipment providers that billed for sleep apnea equipment that patients often did not need.
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In 2014, the government seized more than $110 million in funds and securities from accounts held by individuals and entities involved in the criminal scheme described in the indictment, including Omidi. The government is seeking forfeiture of some or all of those funds in the criminal case, and also intends to pursue civil forfeiture of some or all of the assets.
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[Stuart G]

1. Thank You for finding and posting this..

Very important to show that some doctors will indeed do anything for money...notice I said some I hope these jerks get plenty of jail time. Also, I hope they have to return the money they took..