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Government Strike Force Cracks Down on Medicare Fraud

— May 17, 2021

Federal officials make arrests, settle Medicare fraud cases.

According to court documents, Lilit Gagikovna Baltaian, 58, of Porter Ranch, California, has been arrested Los Angeles on criminal health care fraud charges tied to phony home health certifications and fraudulent billings to Medicare.  Baltaian, a physician, would fraudulently certify patients to receive care from four separate home health agencies, two in Glendale and two in Panorama City, according to federal authorities who are part of the government’s Strike Force.  Those agencies would then file claims to Medicare for reimbursement.

Court documents state, “From approximately January 2012 to July 2018, Lilit Gagikovna Baltaian allegedly 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.  Baltaian allegedly received a cash benefit related to these referrals and also submitted claims to Medicare for signing the fraudulent certifications and for patient visits and injections that were not needed and/or provided.”

Government Strike Force Cracks Down on Medicare Fraud
Photo by Karolina Grabowska from Pexels

As further alleged in court documents, “between January 2012 and July 2018, four home health agencies used Baltaian’s false certifications to submit fraudulent claims to Medicare, resulting in a total of approximately $6,029,674 paid on those claims.”  If convicted, the doctor faces a maximum penalty of a decade behind bars on each count, and she is just one of more than 4,200 defendants The Strike Force has apprehended who have collectively billed the Medicare program for nearly $19 billion, the department said.

Earlier this month, Michael A. Maggiacomo, 50, and Tina M. Allen, 46, both of Newburyport, New Hampshire were each charged with two “Class B felony counts of Medicaid fraud, and two Class A felony counts of theft deception.”  Maggiacomo was also charged with one “Class B felony count of presenting false records, for submitting falsified documents in response to an audit.”

Maggiacomo, the owner of Alerion Home Care and Wellness Solutions, and Allen, an Alerion employee, reportedly submitted claims for payment to New Hampshire Medicaid for home nursing services that were not actually rendered.  The patients in the claims did not reside at the home. And yet, court documents allege, “Between Aug. 1, 2018, and June 30, 2020, Maggiacomo obtained control of over $1,500 in Medicaid funds belonging to the state of New Hampshire.”  Maggiacomo will be arraigned in the Merrimack County Superior Court on June 16, and Allen will be arraigned in the same courthouse on July 1.

Also, this month, a Phoenix hospital, Dignity Health and Neurosurgical Associates, LTD, a corporation that operates on the St. Joseph’s Hospital campus, paid out $10 million to settle a federal court lawsuit alleging neurosurgeons were submitting false claims to Medicare.  The whistleblowing doctor alleged in court documents, surgeons had been “scheduling procedures for multiple patients at the same time,” but he said, “the surgeries were actually performed by inexperienced residents.”  Then, documents submitted to Medicare misrepresented information about the surgeries.

“We expect health care providers participating in Medicare to bill for their services accurately and honestly,” acting U.S. Attorney Glenn McCormick, government Strike Force agent, said. “Proper billing ensures fair compensation and protects Medicare dollars that are much needed for patient care.”


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