November 24, 2014

El Centro Clinic Owner Pleads Guilty to Defrauding Medicare of More Than $1 Million

SAN DIEGO—Gevorg Kupelian, owner of the El Centro Clinic located at 485 Broadway Street in El Centro, California, pleaded guilty today to participating in a conspiracy that targeted the Medicare program and its beneficiaries.

Kupelian admitted to defrauding Medicare by billing for unnecessary procedures, pretending that patients were being seen by medical professionals, and billing for tests and services that were never actually provided.

At today’s hearing, Kupelian admitted that after he leased the premises used by the El Centro Clinic, he found a doctor, hired employees, and recruited “cappers” to bring Medicare beneficiaries to the clinic. While Kupelian and his co-conspirators operated the clinic to give the impression to beneficiaries and outside observers that patients were being seen by qualified medical professionals, in fact, patients would rarely see a doctor or other qualified medical professionals during visits to the clinic.

Kupelian and his co-conspirators caused tests to be performed on the recruited patients without regard to medical necessity, including allergy tests, breathing tests, bladder tests, EKGs, and ultrasounds – all for the purpose of generating bills to Medicare. Kupelian instructed employees that all patients were to undergo all of the tests offered by the clinic, without regard to the patients’ actual diagnoses. Kupelian also created “sample” lab sheets and billing forms with certain tests and diagnoses already requested, and directed employees to simply fill in patients’ names and Medicare beneficiary information. Some tests were never performed at all, and Kupelian inserted phony test results into patient files to make it appear that the tests had been done and results had been appropriately generated.

Kupelian admitted that through the El Centro Clinic, the conspirators fraudulently billed Medicare over $2.7 million and received over $1.285 million in payments. Of that amount, Kupelian’s management company received over $964,000.

Kupelian is next scheduled to appear before the Honorable Larry A. Burns on February 9, 2015 for sentencing.

DEFENDANT: GEVORG KUPELIAN Age: 41

Criminal Case No. 14CR3419-LAB

SUMMARY OF CHARGE

  • Count 1: Conspiracy to commit health care fraud, in violation of 18 U.S.C. § 371.
  • Maximum Penalties: five years’ imprisonment, $250,000 fine, $100 special assessment, restitution.

AGENCIES

  • Federal Bureau of Investigation
  • Health and Human Services, Office of the Inspector General