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West Hollywood Resident Linked to Medicare Fraud Case

This is an article by City News Service:

A dozen Los Angeles-area residents—including the state's second-largest biller for chiropractic services—were taken into custody Tuesday in connection with seven criminal cases alleging they cumulatively submitted more than $22 million in false billings to Medicare.

Those arrested also include a physician's assistant and owners of durable medical equipment and ambulance companies, according to the U.S. Attorney's Office.

In one of the cases, three defendants affiliated with Gardena-based ProMed Medical Transportation, an ambulance company, were charged with submitting more than $5.9 million in false claims to Medicare between 2008 and 2011.

ProMed's owner, Yaroslav Proshak, 45, of Valley Village, general manager Sharetta Wallace, 35, of Inglewood, and office manager and biller Sergey Mumjian, 40, of West Hollywood submitted claims for medically unnecessary transportation services and then created fake documentation purporting to support those claims, the government alleges.

The charges filed in Los Angeles federal court are part of a nationwide crackdown by Medicare Fraud Strike Force operations in eight cities that led to charges against 89 people for their alleged participation in schemes to collectively submit about $223 million in phony claims to Medicare, federal prosecutors said.

The 12 Southland arrestees are among 13 defendants charged in Los Angeles in cases that allege health care fraud. The dozen either were arrested or surrendered to authorities after learning that they had been charged. The 13th defendant is a fugitive.

The defendants include Dr. Houshang Pavehzadeh, of the Sylmar Physician Medical Group, who allegedly billed Medicare more than $1.7 million for chiropractic treatments he never performed.

During the scheme, which ran from 2005 through 2012, Pavehzadeh, 40, of Agoura Hills, became the second-largest Medicare biller in California for chiropractic services—even though he was not in the United States when some of the services were performed, prosecutors allege.

In addition to being charged with health care fraud, Pavehzadeh is charged with aggravated identity theft related to Medicare beneficiaries whose information he used to bill Medicare as a part of the alleged scheme.

When investigators tried to conduct an audit of Pavehzadeh's claims, he falsely reported to the Los Angeles Police Department that he had been carjacked and that patient files requested by the auditors had been stolen from his car, according to federal prosecutors.

Nine defendants affiliated with durable medical equipment companies were also charged in five separate indictments.

Olufunke Fadojutimi, 41, of Carson, a registered nurse; Ayodeji Temitayo Fatunmbi, 41, formerly of Carson, and now believed to be living in Nigeria; and Maritza Velazquez, 40, of Las Vegas, were charged with health care fraud.

The scheme allegedly revolved around Lutemi Medical Supplies, a company Fadojutimi owned and where Fatunmbi and Velazquez worked. According to the indictment in the case, Lutemi billed Medicare more than $8.3 million in claims, primarily for medically unnecessary power wheelchairs.

Fadojutimi and Fatunmbi allegedly laundered Medicare funds in order to purchase fraudulent prescriptions for the power wheelchairs and pay illegal kickbacks to recruit Medicare beneficiaries.

Fadojutimi and Velazquez was arrested today and Fatunmbi is currently a fugitive, according to the U.S. Attorney's Office.

Susanna Artsruni, 45, of North Hollywood, and Erasmus Kotey, 76, of Montebello, a licensed physician's assistant, allegedly worked together to commit health care fraud out of a medical clinic on Vermont Avenue where they both worked.

Kotey allegedly prescribed medically unnecessary equipment, including power wheelchairs, for Medicare beneficiaries. Many of those power wheelchair prescriptions were then used by Artsruni's company, Mid-Valley Medical Supply, to support fraudulent claims to Medicare, prosecutors allege.

In only four months, the clinic and Mid-Valley billed Medicare more than $525,000 for the bogus claims, prosecutors allege.

Artsruni was previously convicted of health care fraud and was on pretrial supervision at the time she allegedly laundered some of the proceeds of the latest fraud.

Three other medical equipment cases were also brought, alleging fraudulent Medicare billing for medically unnecessary power wheelchairs that were sometimes never even delivered.

In one case, Akinola Afolabi, 53, of Long Beach, owner of Emmanuel Medical Supply, allegedly submitted more than $2.6 million in in false and fraudulent billing to Medicare.

In another case, Queen Anieze-Smith, 52, of Encino, and Abdul King- Garba, 47, of Westwood, owner-operators of ITC Medical Supply, allegedly submitted more than $1.8 million in false and fraudulent billing to Medicare, according to court documents.

In the third case, Clement Etim Aghedo, 53, of Fontana, owner of Ace Medical Supply Co., allegedly submitted more than $1.8 in false and fraudulent claims to Medicare.

The charge of health care fraud carries a potential maximum penalty of 10 years in federal prison; money laundering carries a potential 20 years in prison; and aggravated identity theft carries a mandatory two-year prison term.

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