A California physician pleaded guilty today in Los Angeles to criminal health care fraud, arising from her false home health certifications and related fraudulent billings to Medicare.
According to court documents, Lilit Gagikovna Baltaian, 61, of Porter Ranch, was a physician licensed to practice in California and an enrolled Medicare provider. From approximately January 2012 through July 2018, Baltaian falsely certified patients to receive home health care from at least four Los Angeles area home health agencies. Baltaian’s false certifications were used by the home health agencies to fraudulently bill Medicare for the unnecessary home health care. In some instances, Baltaian pre-signed blank, undated physician certification forms knowing that the home health agencies would later falsify the forms to make it appear as if she saw the Medicare beneficiaries and made clinical findings to support the need for home health care, when she had not done either. Baltaian received cash benefits related to these referrals and also submitted claims to Medicare for signing the fraudulent certifications.
Between January 2012 and July 2018, four home health agencies used Baltaian’s false certifications to submit fraudulent claims to Medicare, resulting in loss to Medicare of at least $1,449,050.
Baltaian pleaded guilty to health care fraud. She is scheduled to be sentenced on April 3, 2025, and faces a maximum penalty of 10 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division; Assistant Director in Charge Akil Davis of the FBI Los Angeles Field Office; and Special Agent in Charge Timothy B. DeFrancesca of the Department of Health and Human Services Office of Inspector General (HHS-OIG)’s Los Angeles Regional Office made the announcement.
FBI and HHS-OIG are investigating the case.
Trial Attorneys Matthew Belz and Eric Schmale of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.
This crime news article "Physician Pleads Guilty to Medicare Fraud Scheme" was originally found on https://www.justice.gov/usao/pressreleases