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

Inside
Weather
Santa Clarita CA
Mostly cloudy
Mostly cloudy
40°F
 
Calendar
Today in
S.C.V. History
February 21
1923 - Newhall Chamber of Commerce organized; Albert Swall elected president [story]
Albert Swall


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
Wednesday, Feb 20, 2019
Freeze Watch Called for SCV Thursday Night, Friday Morning
The National Weather Service in Los Angeles/Oxnard issued a Freeze Watch Wednesday afternoon to be in effect in the Santa Clarita Valley from late Thursday night through Friday morning.
Wednesday, Feb 20, 2019
Saugus Man on Probation Charged with Child Porn Possession
A Saugus man convicted last month on two separate misdemeanor driving offenses and on probation was arrested Sunday on suspicion of possessing child pornography, a felony.
Wednesday, Feb 20, 2019
State AG, Assemblyman Intro Bill to Help Curb Rising Drug Prices
California Attorney General Xavier Becerra and Assemblyman Jim Wood (D-Santa Rosa) on Wednesday unveiled legislation to help curb increasing drug prices in California.
Keep Up With Our Facebook

Latest Additions to SCVNews.com
1923 - Newhall Chamber of Commerce organized; Albert Swall elected president [story]
Albert Swall
The Master's University women's track team didn't have any runners qualify for NAIA nationals on Saturday, but the Mustangs did witness several performances that caught the attention of head coach Zach Schroeder.
TMU Women’s Track Opens with Strong Showing at Soka Indoor Event
TMU freshman swimmer Werner hit the NAIA qualifying standard in the 100-yard backstroke Friday at the Pacific Collegiate Swim and Dive Conference Finals in La Mirada.
Barnett, Werner Add Events for NAIA Swim Nationals
The National Weather Service in Los Angeles/Oxnard issued a Freeze Watch Wednesday afternoon to be in effect in the Santa Clarita Valley from late Thursday night through Friday morning.
Freeze Watch Called for SCV Thursday Night, Friday Morning
A group of employees of Valencia-based Boston Scientific has helped the Santa Clarita Valley chapter of PFLAG create and assemble 800 educational packets for local schools.
Boston Scientific Group Helps SCV PFLAG Education Effort
The app displays general cost, coverage and eligibility details for medical items and services covered by Medicare Part A and Part B. You can search or browse to learn what’s covered and not covered; how and when to get covered benefits; and basic cost information.
Free App Shows What Medicare Covers | Commentary by Greg Dill
Eleven highly recognized talents will introduce the eight Best Picture nominees on Oscar Sunday, Feb. 24, announced show producer Donna Gigliotti and co-producer and director Glenn Weiss.
Oscars Telecast Producers Name 11 Best-Picture Presenters
Santa Clarita Valley-based volunteers of AFS Intercultural Programs will host a free informational event about high school foreign exchange student opportunities on Saturday, March 9, from 3 p.m. to 4:30 p.m. at the Valencia Branch of the Santa Clarita Community Library.
March 9: High School Foreign Exchange Student Info Event
New York Times best-selling author Lisa See will make a special visit to Santa Clarita to speak at an author event hosted by the Santa Clarita Public Library at the Newhall Family Theatre for the Performing Arts on Saturday, March 2, starting at 10:30 a.m.
March 2: NYT Best-Selling Author Lisa See to Speak in Newhall
A Saugus man convicted last month on two separate misdemeanor driving offenses and on probation was arrested Sunday on suspicion of possessing child pornography, a felony.
Saugus Man on Probation Charged with Child Porn Possession
After having first protested against Saugus Union School District board member David Barlavi during the Feb. 5 board meeting, a group of protesters carrying signs and waving banners once again attended a SUSD board meeting Tuesday.
Protesters Press for Barlavi Censure or Ouster at SUSD Board Meeting
The five-member Santa Clarita City Planning Commission voted unanimously at its meeting Tuesday night to green-light construction of Building 6 at The Center at Needham Ranch.
City Planners OK Construction of Needham Ranch Building 6
California Attorney General Xavier Becerra and Assemblyman Jim Wood (D-Santa Rosa) on Wednesday unveiled legislation to help curb increasing drug prices in California.
State AG, Assemblyman Intro Bill to Help Curb Rising Drug Prices
Now into its third week, prosecutors continued presenting their case to the jury in the trial of a truck driver accused of manslaughter in the deaths of two women and four children killed in 2016.
Prosecutors Present Evidence in Week 3 of Vehicular Manslaughter Trial
The Los Angeles County District Attorney's Office posted on its website on Tuesday eight officer-involved shooting reports for the month of January 2019.
LA County DA Posts Officer-Involved Shooting Reports for Jan. 2019
Governor Gavin Newsom promised leaders in Southern California on Tuesday the state would back them financially if they build their share of affordable housing to stem the state’s affordability woes.
Newsom Vows Money, Lawsuits to Ease California Housing Crisis
Adding to the long list of obstacles blocking California’s bullet train designs, the Trump administration announced Tuesday it was nixing $929 million in federal funding for a project meant to connect the state’s largest cities by high-speed rail.
President Demands Return of Federal Dollars Spent on Bullet Train
State tax revenue reported by the cannabis industry totaled $103.3 million for 4th quarter 2018 returns due by Jan. 31, 2019, according to numbers reported Tuesday by the California Department of Tax and Fee Administration.
Cannabis Sales Generate $103M in Tax Revenue for 4Q 2018
Santa Clarita Valley Sheriff's Station deputies searching for a gunman who held up the Castaic Truck Stop early Tuesday morning ended up arresting two men unrelated to the holdup.
Deputies Arrest 2 on Gun Charges in Castaic; Truck Stop Robber at Large
A California judge lifted a temporary seal on Los Angeles police misconduct records Tuesday, striking a blow to police unions that say unsealing the records violates officers’ constitutional rights to privacy.
LA Judge Orders Police Misconduct Records Unsealed
1906 - L.A. County accepts Mr. H.C. Register's bid to build (Old) Newhall Jail for $2,237 [story]
Old Newhall Jail
Members of the SCV Water Agency board, who found themselves saying goodbye to two of their fellow directors this past year, have called a special meeting Tuesday to talk about obtaining permission to reduce the size of the board should there be any more attrition.
SCV Water to Discuss Reducing Board Size
The next regular meeting of the Governing Board of the William S. Hart Union High School District is set for 7:00 p.m., Wednesday, February 20, at the Administrative Center, 21380 Centre Pointe Parkway, Santa Clarita 91350.
Feb. 20: Hart District Governing Board Regular Meeting
The Los Angeles County Board of Supervisors approved a motion Tuesday authored by Supervisors Sheila Kuehl and Mark Ridley-Thomas to phase out the use of oleoresin capsicum spray (pepper spray) in County juvenile facilities.
Supes Approve Motion to Phase Out Pepper Spray in Juvenile Facilities
The Los Angeles County Department of Public Social Services (DPSS) announces that the full amount of CalFresh benefits for March will be issued on March 1, 2019 to eligible households.
County to Issue Single-Day CalFresh Benefits
LOS ANGELES – The Los Angeles County Health Officer is extending a Cold Weather Alert due to the National Weather Service’s forecast for low temperatures. Wind chill temperatures are expected to be below 32 degrees Fahrenheit. Affected areas include:
County Officials Issue Cold Weather Alert for SCV
Castaic Union School District is proud to announce the recipients of the Castaic Schools Teacher of the Year Award.
Northlake Hills Teacher Named Castaic Union’s Teacher of the Year
A woman was killed after her car went underneath a semi truck on the northbound side of Interstate 5 Tuesday, according to CHP officials.
Woman Killed in Collision on I-5 Truck Route
Stars continue to line up to present on the Oscars - the year’s most-watched, live entertainment event - on Sunday, February 24, announced show producer Donna Gigliotti and co-producer and director Glenn Weiss.
Academy Announces New Round of Oscar Presenters
College of the Canyons has created a Continuing Education Survey to identify the unique and specific needs of the Santa Clarita Valley community.
COC Requesting Community Input on Continuing Education
Henry Mayo Newhall Hospital is hosting its third annual CARE SCV, a Cancer Awareness & Resource Expo, at the College of the Canyons Dr. Dianne G. Van Hook University Center on Saturday, March 2, from 8:00 a.m. to 1:00 p.m.
March 2: CARE SCV Cancer Awareness, Resource Expo at COC
Princess Cruises, the world’s largest international premium cruise line, is growing and today major milestones for three ships under construction at the same time were celebrated, at Fincantieri Shipyard in Monfalcone, Italy.
Princess Cruises Highlights Progress of Three of Its Newest Ships
LANCASTER – The University of Antelope Valley Pioneers (2-9-1) fell to the Warriors of Lewis-Clark State College (4-4-1) in game one on Sunday, 13-6, and the two teams would finish game two in a 2-2 draw in non-conference NAIA baseball action at the Hangar.
Pioneers Face Off Against Lewis-Clark State College
Payless ShoeSource joins the line of retail chains soon to close down in the United States.
Payless Closing All 2,100 Stores
Senator Scott Wilk, (R-Santa Clarita), announced Tuesday that he has introduced Senate Bill 333 (SB 333), a measure to address California's homeless crisis by requiring the Homeless Coordinating and Financing Council (HCFC) to develop and implement a long-term, strategic plan to combat homelessness across the state, complete with specific goals and benchmarks.
Wilk Intros Bill Addressing Statewide Homeless Crisis
Washington, DC – Vice Chair of Oversight and Government Reform Committee Congresswoman Katie Hill, (D-Santa Clarita), introduced H.R. 1064, a bill that allows whistleblowers to report concerns about classified programs directly to their supervisors and up their chain of command.
Hill’s Whistleblower Bill Passes House