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

Inside
Weather
Santa Clarita CA
Sunny
Sunny
86°F
 
Calendar
Today in
S.C.V. History
October 21-22
2007 - Buckweed fire chars 38,000 acres, destroys 21 homes in Canyon Country and Agua Dulce [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 Reply


SCV NewsBreak
LOCAL NEWS HEADLINES
Friday, Oct 19, 2018
Unwanted Sexual Encounter Reported at COC
College of the Canyons administrators alerted students and faculty Friday morning to a report of an unwanted sexual encounter Thursday in a COC restroom.
Friday, Oct 19, 2018
Red Flag Warning Flies Till 10 Friday Night
The National Weather Service issued an urgent red flag warning at 3 p.m. Friday that will remain in effect in the Santa Clarita Valley until 10 p.m. due to gusty Santa Ana wind and low humidity.
Friday, Oct 19, 2018
State Voters Eye Ballot Measures for Solutions to Housing Crisis
In less than three weeks, California’s 19 million voters will decide a slate of midterm ballot measures aimed at easing the state’s affordable housing crisis, but not all initiatives may bring residents the relief they seek.
Keep Up With Our Facebook

Latest Additions to SCVNews.com
Here is the Santa Clarita Valley Football Roundup for Week 9 of the 2018 season. College of the Canyons remains undefeated with a win against East LA, while Hart handed West Ranch its first defeat of the season.
Santa Clarita Valley Football Roundup
2007 - Buckweed fire chars 38,000 acres, destroys 21 homes in Canyon Country and Agua Dulce [story]
1873 - Santa Barbara lawyers Charles Fernald and J.T. Richards purchase Rancho San Francisco for $33,000 (75 cents an acre) in a sheriff's sale [story]
The annual "Fun in the Sun" Chili Cook-Off staged by the Los Angeles County Sheriff’s Department to benefit the Special Olympics is set for Saturday, Oct. 20 from 11 a.m to 4 p.m. at the Jack Bones Equestrian Center in Castaic.
Oct. 20: LASD ‘Fun in the Sun’ Chili Cook-Off to Benefit Special Olympics
College of the Canyons administrators alerted students and faculty Friday morning to a report of an unwanted sexual encounter Thursday in a COC restroom.
Unwanted Sexual Encounter Reported at COC
Brian O’Connor has been promoted to vice president brand and corporate communication at Santa Clarita-based Princess Cruises.
Princess Cruises Ups O’Connor to VP Brand, Corporate Communications
Santa Clarita City Councilmembers on Tuesday night will discuss how to respond to county planners' request that developers consider a homeless shelter in Phase II of the proposed Tesoro del Valle housing project just north of city limits.
Oct. 23: City to Weigh Response to County Idea for Tesoro Homeless Shelter
The Santa Clarita City Council will hold its next meetings at City Hall on Tuesday, Oct. 23.
Oct. 23: Santa Clarita City Council Regular, Special Meetings
The National Weather Service issued an urgent red flag warning at 3 p.m. Friday that will remain in effect in the Santa Clarita Valley until 10 p.m. due to gusty Santa Ana wind and low humidity.
Red Flag Warning Flies Till 10 Friday Night
The registration deadline to vote in the Nov. 6 General Election is Monday, Oct. 22, at 11:59 p.m.
Oct 22: Last Day to Register to Vote in Nov. 6 Election
In less than three weeks, California’s 19 million voters will decide a slate of midterm ballot measures aimed at easing the state’s affordable housing crisis, but not all initiatives may bring residents the relief they seek.
State Voters Eye Ballot Measures for Solutions to Housing Crisis
The next meeting of the Los Angeles County Board of Supervisors is set for Tuesday, Oct. 23, starting at 9:30 a.m.
Oct. 23: LA County Board of Supervisors Meeting
Lane closures on Soledad Canyon Road due to film-related activity near the Saugus Speedway will begin at 10:30 p.m. Tuesday and end at approximately 4 a.m. Wednesday, according to an alert from the city of Santa Clarita.
Lane Closures on Soledad for Filming Set for Tuesday Night
Night work on the city of Santa Clarita's Sierra Highway pedestrian bridge project will take place at the construction site on Sierra Highway north of Golden Valley Road on Tuesday, Oct. 23, from 8 p.m. to 4 a.m.
Oct. 23: Night Work on New Sierra Highway Pedestrian Bridge
East LA College will visit Cougar Stadium Saturday night, and all SCV youth football and cheer teams — Santa Clarita Cowboys, Grizzlies, Spartans, Vikings, Warriors, Wildcats and teams from other parks and recreation programs — are invited to attend the game free of charge when wearing a school jersey or uniform.
COC Invites SCV Youth Football, Cheer Programs to Saturday’s Game
To increase awareness about school bus safety among motorists, parents, teachers and students, the California Highway Patrol will observe National School Bus Safety Week Oct. 22-26.
Oct. 22-26: CHP Rides with School Bus Safety Week
Oct. 21-27 is National Teen Driver Safety Week, and the Los Angeles County Sheriff Department wants to remind parents and guardians the importance of talking to their teen drivers about new responsibilities and rules that come with operating a vehicle.
Oct. 21-27: LASD Rolls with National Teen Driver Safety Week
Santa Clarita Valley Sheriff’s Station deputies arrested a Long Beach man on multiple charges for weapons and drugs earlier this week, according to officials.
SCV Deputies Arrest Long Beach Man in Gorman on Multiple Charges
1945 - Acton Hotel, est. 1890, burns down; arson is suspected [story]
The Los Angeles County Department of Parks and Recreation presents its latest “Recreation After Dark” event, “Goin’ Country at Hart.”
Oct. 19: Goin’ Country at Hart to Feature Moldy Marvin, Highway 138
ARCADIA, Calif. — On Wednesday, Jerry Perez officially reported to the Angeles National Forest and San Gabriel Mountains National Monument, where he will serve as the new Forest Supervisor, replacing Jeff Vail, who accepted the position of deputy director for Recreation, Heritage and Volunteer Resources in the Forest Service’s Washington Office.
New Angeles National Forest Supervisor Excited About New Position
Le Chene French Cuisine has announced that they will be hosting two special events coming to you in November.
Le Chene Invites Residents to November Celebrations
The Valencia High School Marching Band and Color Guard held their first major fundraising event for their band season.
Valencia High School Marching Band Appreciates Support from Community
The city of Santa Clarita will present three music-related sessions at the 2018 Arts Symposium at The Centre on Saturday, Oct. 20.
Oct. 20: Art Symposium to Stage 3 Music Sessions
It makes good sense to review your coverage each year. Make sure your plan still is a good fit for you in terms of cost, coverage, and quality.
How to Shop for Medicare Plans | Commentary by Greg Dill
StarKist Co. has agreed to plead guilty for its role in a conspiracy to fix prices of packaged seafood sold in the United States, the Department of Justice announced Thursday.
StarKist Pleads Guilty to Price Fixing
The First Presbyterian Church of Newhall will be performing “The Green Velvet Christmas Dress.”
Newhall Church to Present ‘The Green Velvet Christmas Dress’
Decorated with fun embellishments such as puffy paint, tulle fabric, feathers and even bubble wrap, artist Georgette Arison’s mixed-media art in “Dressing Up is Fun,” the newest art exhibit at the Newhall Community Center, uses unconventional methods to showcase costume design.
‘Dressing Up is Fun’ Exhibit Now Showcasing at Newhall Community Center
Celebrating its 5th anniversary this year, the Santa Clarita Oktoberfest is a Southern California twist on the original Oktoberfest held annually in Munich, Bavaria, Germany.
Oct. 19, 20: Santa Clarita Oktoberfest
College of the Canyons has been ranked No. 29 by the Hispanic Outlook on Education Magazine’s Top 100 colleges and universities list for graduating Hispanic students.
Hispanic Outlook Ranks COC No. 29 on Top 100 List
Maj. Stephen Del Bagno, a United States Air Force Thunderbirds pilot and a graduate of Saugus High School who died on April 4 during a routine aerial training flight in the Nevada Test and Training Range, lost consciousness before the fatal crash, according to a report released by the Air Force.
Report: Santa Clarita Thunderbirds Pilot Lost Consciousness Before Crash
SAN FRANCISCO – The U.S. Environmental Protection Agency (EPA) announced Monday an agreement with the U.S. Forest Service (USFS) to close 62 campground pit toilets, considered to be large capacity cesspools, at seven national forests across California.
Forest Service Forced to Close Cesspools in State’s National Forests
The Los Angeles County Commission on Human Relations (LACCHR) released its annual account Wednesday of hate crimes reported throughout Los Angeles County in 2017.
LA County Hate Crimes Continue to Rise
Sheriff Jim McDonnell has named Sergio Perez, a Los Angeles native, as his Constitutional Policing Advisor to assist the Los Angeles County Sheriff’s Department (LASD) in sustaining reform and advancing justice for the diverse communities we serve.
LASD Names New Constitutional Policing Adviser
Every year, department members who perform acts of great courage and heroism, who go above and beyond the call of duty to save the lives of others while placing their own lives at risk, are honored and recognized at the Los Angeles County Sheriff’s Department Medal of Valor Awards Ceremony.
LASD Department Members, Private Citizens Recognized at Award Ceremony
1876 - Southern Pacific begins subdividing town of Newhall (original location at Bouquet Junction) [story]