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August 18, 2015

Owner of Three Los Angeles Clinics Pleads Guilty to $4.5 Million Medicare Fraud Scheme

WASHINGTON—The owner and operator of three medical clinics located in Los Angeles pleaded guilty today to submitting more than $4.5 million in fraudulent claims to Medicare.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Eileen M. Decker of the Central District of California, Acting Special Agent in Charge Steve Ryan of the U.S. Department of Health and Human Services’ Office of Inspector General of the (HHS-OIG) Los Angeles Region and Assistant Director in Charge David Bowdich of the FBI’s Los Angeles Division made the announcement.

Hovik Simitian, 48, of Los Angeles, pleaded guilty before U.S. District Court Judge Beverly Reid O’Connell of the Central District of California to one count of conspiracy to commit health care fraud. Sentencing has been scheduled for Nov. 16, 2015.

Simitian owned and operated three medical clinics that were located in the Los Angeles area: Columbia Medical Group Inc., Life Care Medical Clinic and Safe Health Medical Clinic. In connection with his guilty plea, Simitian admitted that, from approximately February 2010 through June 2014, he and his co-conspirators paid cash kickbacks to patient recruiters who brought Medicare beneficiaries to the clinics. Simitian also admitted that he and his co-conspirators billed Medicare for lab tests and other services that either were not medically necessary or were not actually provided to the Medicare beneficiaries, and that, to support the bills to Medicare, he and others created false documentation reflecting that the services had been provided.

Simitian further admitted that, between February 2010 and June 2014, he and his co-conspirators submitted approximately $4,526,791 in false and fraudulent claims to Medicare. Medicare paid approximately $1,668,559 of those claims.

The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. This case is being prosecuted by Trial Attorneys Blanca Quintero and Alexander F. Porter of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

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