[Sign Up Now] to Receive Our FREE Daily SCVTV-SCVNews Digest by E-Mail

Inside
Weather
Santa Clarita CA
Cloudy
Cloudy
51°F
 
Calendar
Today in
S.C.V. History
January 16
1926 - Newhall Community Hospital, est. 1922, opens in larger, more modern hospital building at 6th & Spruce streets [story]


Gary Jizmejian, 44, a Santa Clarita resident and a former senior investigator with the Anthem health care organization, was one of five people arrested on federal health care fraud charges on Tuesday, according to the U.S. Attorney’s Office of the Central District of California.

A federal grand jury indictment unsealed Tuesday morning alleges that the five defendants – including
Jizmejian, formerly with the Anthem Special Investigations Unit, Anthem’s in-house anti-fraud unit – were linked to two San Fernando Valley clinics and engaged in a multi-year conspiracy to commit health care fraud against at least eight health insurance companies.

The indictment alleges the defendants submitted fraudulent claims to the health insurance companies and used some of the fraud proceeds to provide patients with “free” cosmetic procedures.

Read the complete indictment here.

Those arrested include the owner and operator of the clinics, Roshanak Khadem, also known as “Roxanne” and “Roxy” Khadem, 50, of Sherman Oaks.

Khadem owned and operated the two clinics at the center of the alleged scheme – R&R Med Spa, which was located in Valley Village until early 2016, and its successor company, Nu-Me Aesthetic and Anti-Aging Center, which operated in Woodland Hills.

The indictment alleges that Khadem and others induced patients to visit the clinics to receive free cosmetic procedures – including facials, laser hair removal and Botox injections – which were not covered by insurance.

The conspirators obtained the insurance information from the patients and fraudulently billed insurance companies for unnecessary medical services or for services that were never provided. Using the fraudulent proceeds from the insurance companies, Khadem and other conspirators calculated a “credit” that patients could use to receive “free” or discounted cosmetic procedures.

During the course of the conspiracy, Khadem and her conspirators submitted at least $20 million in claims to the insurance companies, which paid approximately $8 million on those claims, according to the indictment.

The other three defendants arrested were:

* Dr. Roberto Mariano, 59, of Rancho Cucamonga, a physician who helped operate the clinics;

* Marina Sarkisyan, 49, of Panorama City, who was the office manager at the clinics;

* Lucine Ilangezyan, 38, of North Hills, an employee and insurance biller for the clinics; and

All five defendants were arraigned on the indictment Tuesday afternoon in United States District Court in downtown Los Angeles.

The indictment specifically alleges that, in return for cash payments, Jizmejian assisted Khadem and others by providing them with confidential Anthem information that helped them submit fraudulent bills to Anthem.

In September 2012, Jizmejian gave Khadem insurance billing codes – CPT Codes – that Jizmejian knew could be used to submit fraudulent claims to Anthem without Anthem detecting the fraudulent claims.

Jizmejian gave Khadem the billing code for an allergy-related lab test and instructed her to submit to Anthem large numbers of bills with this CPT code. Khadem and other members of the conspiracy used this billing code to submit approximately $1 million in fraudulent claims to Anthem, according to the indictment.

The indictment further alleges that Jizmejian worked to prevent the insurance companies from detecting the fraud at the clinics, which included helping Khadem to avoid responding to inquiries from fraud investigators, diverting the attention of other Anthem SIU investigators away from the clinics, and closing Anthem investigations into the fraud that was being committed at the clinics.

In September 2015, based on confidential information obtained from Anthem, Jizmejian tipped Khadem off about a federal criminal investigation into the clinics, according to the indictment.

The scheme involving the two clinics allegedly defrauded the International Longshore and Warehouse Union, Pacific Maritime Association Benefit Plan, which is the health benefit plan that covers longshore workers in Southern California and their dependents, according to the indictment. Another victim was the Federal Employees Health Benefits Program, which provides health insurance for federal employees.

An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty.

All five defendants are charged with one count of conspiracy to commit health care fraud and 13 counts of health care fraud. The indictment contains criminal forfeiture allegations that seek forfeiture of the ill-gotten gains derived from the offense.

Each count charged in the indictment carries a statutory maximum sentence of 10 years in prison.

This case was investigated by the United States Department of Labor, Office of Inspector General; the United States Department of Labor, Employee Benefits Security Administration; and the Office of Personnel Management, Office of Inspector General. The United States Marshals Service is providing assistance relating to the asset forfeiture investigation. Anthem Blue Cross has been cooperating with the investigation involving its former employee.

The case is being prosecuted by Assistant United States Attorney Alexander F. Porter of the Major Frauds Section.

Comment On This Story
COMMENT POLICY: We welcome comments from individuals and businesses. All comments are moderated. Comments are subject to rejection if they are vulgar, combative, or in poor taste.
REAL NAMES ONLY: All posters must use their real individual or business name. This applies equally to Twitter account holders who use a nickname.

2 Comments

  1. Roger says:

    White collar crime maybe these people might meet MS13 crime in jail. I don’t think they will see Prison since they aren’t illegal immigrants or persons of color.

  2. pj says:

    Due to people like this, Our medical insurance is insane. Roger is so right!

Leave a Comment


SCV NewsBreak
LOCAL NEWS HEADLINES
Tuesday, Jan 15, 2019
Flash Flood Watch in Effect, Bouquet Canyon Road Closed at San Francisquito
A flash flood watch is in effect in the Santa Clarita Valley until Tuesday evening. The following is from the social media account of the Santa Clarita Valley Sheriff's Station:
Tuesday, Jan 15, 2019
Mandatory Evacuations Underway for Portions of Woolsey Fire Burn Area
Unified Command has identified properties in the Woolsey fire burn area that may be subject to a high volume of mud and debris flow. Los Angeles County Sheriff’s Department personnel will be out to give residents at the identified properties advance evacuation notice. Mandatory evacuations began at 8:00 a.m. Tuesday.
Tuesday, Jan 15, 2019
Acosta Confirmed to SCV Water Board
The SCV Water Board of Directors confirmed Los Angeles County Supervisor Kathryn Barger’s appointment of former Assembly member Dante Acosta to its Board of Directors at its special Board meeting, Monday, Jan. 7.
Keep Up With Our Facebook

Latest Additions to SCVNews.com
1926 - Newhall Community Hospital, est. 1922, opens in larger, more modern hospital building at 6th & Spruce streets [story]
Most doctors accept Medicare as full payment for their services. But some accept it only for certain services, and others don’t accept it at all. What does this mean for you?
Keep Your Medicare Costs Down
An oil painting demo by Lynne Fearman will be held on Monday, Feb. 18, at the meeting of the Santa Clarita Artists Association (SCAA).
Feb. 18: Oil Painting Demo by Lynne Fearman
The Los Angeles County Board of Supervisors on Tuesday approved $500,000 in funding to repair the 1.8-mile-long Canyon Trail at Placerita Canyon Natural Area and Nature Center, which sustained major damage following the Sand Canyon Fire in 2016.
Placerita Nature Center to Undergo Repairs from Sand Fire Damage
The next regular meeting of the Governing Board of the William S. Hart Union High School District is set for Wednesday, at the Administrative Center, 21380 Centre Pointe Parkway, Santa Clarita 91350.
Jan. 16: Hart District Governing Board Regular Meeting
SCV Water's Public Outreach and Legislation Committee is scheduled to meet on Thursday at 5:30 p.m.
Jan. 17: SCV Water Public Outreach, Legislation Committee Meeting
The California Enterprise Development Authority will hold a teleconference meeting Thursday at 10:30 a.m.
Jan. 17: California Enterprise Development Authority Teleconference Meeting
The Canyon Country Advisory Committee (CCAC) will hold its first meeting of 2019 on Wednesday from 7:00 p.m. - 9:00 p.m.
Jan. 16: Canyon Country Advisory Committee Meeting
The Santa Clarita Community College District’s Board of Trustees will hold its next business meeting at College of the Canyons’ Valencia campus on Wednesday.
Jan. 16: COC Board of Trustees Business Meeting
A flash flood watch is in effect in the Santa Clarita Valley until Tuesday evening. The following is from the social media account of the Santa Clarita Valley Sheriff's Station:
Flash Flood Watch in Effect, Bouquet Canyon Road Closed at San Francisquito
Forty-five amateur chefs are sweating it out in the kitchen, preparing to compete in the 7th Annual SCV Charity Chili Cook-off. People’s Choice and Judges Choice prizes will be awarded to the top three chili’s in each category.
March 21: Annual SCV Charity Chili Cook-Off
MESA, Ariz. – The University of Antelope Valley Pioneers (6-11; 4-1 Cal Pac) earned their fourth conference win on Saturday afternoon, handily defeating the Redhawks of Benedictine University at Mesa (13-7; 2-3 Cal Pac), 92-75, in intercollegiate California Pacific Conference men’s basketball action inside Heap Gymnasium.
Pioneers Cruise to 4th Conference Win
MESA, Ariz. – After a late rally, the University of Antelope Valley Pioneers (14-4; 4-1 Cal Pac) would go on to win in overtime on Saturday, defeating the Redhawks of Benedictine University at Mesa (5-9; 1-4 Cal Pac), 77-74, in intercollegiate California Pacific Conference women’s basketball action inside Heap Gymnasium.
Lady Pioneers Rally Past Benedictine University
Because of the recent rainfall, Los Angeles County Health Officer, Muntu Davis, MD, MPH, is cautioning residents who are planning to visit Los Angeles County beaches to avoid swimming, surfing, and playing in ocean waters around discharging storm drains, creeks, and rivers. Bacteria, chemicals, debris, trash, and other public health hazards from city streets and mountain areas are likely to contaminate ocean waters at and around these outlets after a rainfall.
Beach Water Advisory Extended Until Thursday
Valencia-based Bioness, Inc., the leading provider of advanced, clinically supported medical devices for the treatment of chronic pain of peripheral nerve origin, has launched the first and only Patient Registry for peripheral nerve stimulation (PNS) using its StimRouter Neuromodulation System.
Valencia-based Bioness Intros First Peripheral Nerve Stimulation Registry
The DECA Chapter from Valencia High School recently competed in the 2019 Southern California Career Development Conference.
Vikings Earn Top 3 at So Cal Career Conference
NORTHRIDGE - After leading CSUN Men's Basketball to a pair of road wins to start conference play, sophomore Terrell Gomez has received Big West Player of the Week accolades, the league office announced on Monday.
Matadors Sophomore Earns Big West Player of the Week
This year, Le Chène French Cuisine will be hosting a Murder Mystery Dinner on Valentine's Day, Thursday, Feb. 14 at 7:00 p.m.
Feb. 14: Le Chène’s Valentine’s Day Murder Mystery Dinner
Evacuation centers are now open for the Woolsey Fire burn areas.
Evacuation Centers Now Open for Woolsey Fire Burn Areas
Unified Command has identified properties in the Woolsey fire burn area that may be subject to a high volume of mud and debris flow. Los Angeles County Sheriff’s Department personnel will be out to give residents at the identified properties advance evacuation notice. Mandatory evacuations began at 8:00 a.m. Tuesday.
Mandatory Evacuations Underway for Portions of Woolsey Fire Burn Area
The SCV Water Board of Directors confirmed Los Angeles County Supervisor Kathryn Barger’s appointment of former Assembly member Dante Acosta to its Board of Directors at its special Board meeting, Monday, Jan. 7.
Acosta Confirmed to SCV Water Board
The city of Santa Clarita Planning Commission will hold its regular meeting Tuesday at 6:00 p.m.
Jan. 15: Santa Clarita Planning Commission Regular Meeting
Caltrans urges motorists to be prepared and use caution when driving this winter. Taking action and being proactive can help reduce the risk of injury and even death on the highways during the upcoming storm. Operators of vehicles must use their best judgment in all types of weather.
Caltrans Offers Winter Driving Safety Tips
1875 - Henry Mayo Newhall buys western half of the Santa Clarita Valley for $2 an acre [story]
A 22-year-old Palmdale man died on Bouquet Canyon Road early Monday morning in a solo crash believed to be caused by excessive speed, according to the California Highway Patrol's Newhall Area office.
Palmdale Man Dies in Solo Crash on Bouquet Canyon Road
All half, the ball had been flying out of Darryl McDowell-White's hands and diving into the bottom of the net.
Men’s Hoops: McDowell-White, Johnson Lead Master’s over Westmont
Surging to an early lead and showcasing a dominating defense that has been the squad's hallmark over the past 10 games, the No. 21-ranked Mustangs led wire-to-wire in a 58-48 win over No. 15 Westmont.
Women’s Hoops: Stingy Mustang Defense Keys Win Over No. 15 Westmont
Newhall School District officials are hosting a series of parent information nights this week about the district's Dual Language Immersion Program for English- and Spanish-speaking students.
Jan. 14, 16: Newhall School District Info Nights on English-Spanish Dual Immersion
The Federal Emergency Management Agency has extended the registration period for Los Angeles County residents affected by the recent wildfires to apply for disaster assistance to Jan. 31.
FEMA Extends Wildfire Aid Application Deadline to Jan. 31
The Cougars had four players score in double figures and shot a combined 48.2 percent from the field, but could not hold off the Ventura Pirates in an 86-81 loss on Friday in the Cougar Cage.
Men’s Hoops: Cougars Fall 86-81 to Visiting Pirates
College of the Canyons will offer a Google IT Support Professional Certificate course in March, at no cost to anyone.
COC Offers Free Online Course for Google IT Support Certificate
To better assist high school seniors with the transition to collegiate life, College of the Canyons will offer information nights on Jan. 15 and 16 at the Santa Clarita Performing Arts Center and at Canyon High School on Thursday, Jan. 17.
Jan. 15-17: COC Sets Info Nights at Pac, Canyon High School
Officers from the California Highway Patrol Newhall Area station have closed northbound Interstate 5 at Parker Road in Castaic due to snow in the Grapevine and Tejon Pass.
Grapevine Snow Prompts CHP to Close I-5 Northbound at Parker Road
Magnified by a 2016 case in which doctors removed an infant from life support over the parents’ objections, a fight over California’s longstanding standard on brain death sharpened Monday at the Ninth Circuit.
California Brain-Death Standard Debated at 9th Circuit
A GoFundMe crowdfunding campaign has been established to help the nonprofit Santa Clarita Artists Association replace equipment damaged or destroyed in a storage locker fire on Jan. 7.
GoFundMe Campaign Set Up to Aid Santa Clarita Artists Association
The city of Santa Clarita has updated the list of productions shooting in the city and the Santa Clarita Valley for the week of Jan. 14-20, 2
‘Goliath,’ Anjelica Video, ‘F.U. Guys’ Feature Now Filming in SCV