LOS ANGELES—A former weight-loss doctor and a Beverly Hills doctor faced lawsuit Tuesday for allegedly involving 1-800-GET-THIN lap-band surgery in a $250 million fraudulent billing scheme.
Julian Omidy, 53, of West Hollywood, and Mirali Jarrabi, 59, of Beverly Hills, have been charged with multiple federal counts of mail and wire fraud, false statements, money laundering, identity theft resulting from 0 and Get Thin’s lap-band surgery. Has been charged. and sleep study schedules between May 2010 and March 2016, according to the U.S. Attorney’s Office.
Surgery Center Management, a corporation controlled by Omidy, along with his brother and mother, is also named in the indictment. A Lap-Band is a silicone ring that is surgically implanted around the stomach to discourage overeating.
Prosecutors allege that the alleged fraud scheme resulted in harm to patients when they were subjected to unnecessary medical procedures, and harm to insurance providers when they paid tens of millions of dollars after receiving fraudulent bills.
Omidi, a physician whose license was revoked in 2009, controlled, in part, the GET THIN network of companies that focused on the promotion and demonstration of elective, lap-band weight-loss surgery.
According to the indictment, Omidy established procedures requiring potential Lap-Band patients—even those covered by insurance plans they knew would never cover Lap-Band surgery— Commissions were offered to conduct at least one sleep study, and to ensure that the employees. .
According to the website of the state medical board, Jarrabi is a doctor whose license is still in good standing.
The purpose of the sleep studies was to find a second cause — such as sleep apnea — that Get Thin would be used to convince a patient’s insurance company to pre-approve the Lap-Band procedure, federal prosecutors allege.
The US Attorney’s Office argues that after sleep studies of patients—often accompanied by an indication that a doctor had ever determined that the study was medically necessary—obtain staff allegedly acting on OMD’s instructions. falsify the results to show that the patient
had moderate or severe sleep apnea, and that they suffered from severe daytime sleepiness.
According to the indictment, Omidy caused those false sleep study reports to be used in support of Get Thin’s pre-authorization requests for lap-band surgery.
Relying on false sleep studies as well as other false information including patients’ height and weight, insurance companies reportedly authorized payment for some proposed Lap-Band surgeries. The indictment alleges that Get Thin received at least $38 million for lap-band procedures.
Even though the insurance company did not authorize the surgery, Get Thin was able to collect bills of $15,000 for each sleep study, according to the indictment. Prosecutors said the insurance payments were deposited into bank accounts linked to GET THIN entities.
Federal prosecutors said health care benefits programs allegedly victimized by the billing scam include TriCare—a health care program for uniformed service members, retirees and their families around the world—and various private insurance companies.
If convicted as charged, Omidy and Zarrabi could face up to 20 years in prison for each of the alleged mail fraud and wire fraud counts in the indictment alone.
The trial in Los Angeles federal court can take up to two or three months.
The government has about four dozen witnesses it plans to call, including two associate defendants, court papers show. According to the prosecution’s memorandum of trial, Omidy’s lawyers provided a list of witnesses of 96 people, including a deceased GET THIN patient.
As part of their case, federal prosecutors alleged that Jarrabi allowed his electronic signature to be used by Get Thin to make it appear that he had reviewed false sleep studies, even though he knew that According to the indictment, the report was being modified. Jarrabi also reportedly sought to pay for the use of his electronic signature on hundreds of prescriptions for devices to treat sleep apnea.
Dave Jones, California’s then-insurance commissioner, said at the time of the indictment, Jarrabi and Omidy “hunted countless patients when they allegedly provided medically unnecessary treatment to increase their own profits by tens of millions of dollars.”
“Medical provider fraud is a multi-billion dollar problem that drives up health insurance premiums and creates a drain on our economy,” he said.
This News Originally From – The Epoch Times