Operators of TJD Medical Center and Rehab Indicted for Health Care Fraud

DENVER—Dilorom Asimova, age 50, of Aurora, Colorado, surrendered today to federal agents in Denver, and Terry Gardner, age 62, of Chesterfield, Missouri, was arrested yesterday by federal agents in St. Louis, based on a sealed grand jury indictment returned on May 17, 2010, charging both defendants with health care fraud. Asimova will appear this afternoon in U.S. District Court in Denver, where she will be advised of the charges pending against her, and the associated penalties. Gardner appeared yesterday in U.S. District Court in St. Louis, Missouri, where he was advised of the charges and associated penalties pending against him.

According to the indictment, TJD Medical Center and Rehab was a Colorado corporation formed on August 19, 2003, by three individuals, including defendants Asimova and Gardner. TJD had two office locations, one in Wheat Ridge, and the other in Aurora. Asimova was the original registered agent, although that later was changed to Gardner being the registered owner. TJD was a medical practice which served both Medicare and Colorado Medicaid, as well as other private and government sponsored health insurance programs. TJD was allowed to submit Medicare claims for reimbursement electronically rather than by mail.

Gardner, the owner of TJD, is a licensed commercial airline pilot. He has also been a licensed physician in Colorado since May 25, 2001. Gardner could not dedicate his full-time employment to TJD because he was also working as a full-time commercial airline captain for Trans States Airlines based out of St. Louis, Missouri. At no time was Asimova a licensed doctor in Colorado or any other state in the U.S.

From October 2003, and continuing until February 2009, the indictment alleges that Asimova and Gardner did knowingly and willfully conspire with each other and others to execute a scheme to defraud Colorado Medicaid and Medicare programs in connection with the delivery of payment for health care benefits. Further, the two defendants allegedly made materially false statements and writings to Colorado Medicaid and Medicare in connection with the delivery of health care benefit payments.

As part of the conspiracy, the defendants held out to patients that Asimova was a doctor authorized to practice medicine in Colorado. Thus, Asimova diagnosed and treated patients at TJD. The defendants then billed Medicare and Colorado Medicaid for services that were performed by Asimova and other unlicensed individuals, without the direct supervision of a licensed doctor. The two defendants also billed Medicare and Colorado Medicaid for services never provided. In addition, the defendants billed Medicare and Medicaid for services supposedly provided by Gardner or in his immediate presence, when in truth Gardner was acting as a commercial airline pilot during the times relevant to those services supposedly being provided. Lastly, the defendants misrepresented that medical services provided were “face-to-face” as required, although Asimova, who saw the patients, was not a doctor and was not licensed in any way to see patients.

“This is an important case to protect the integrity of the health care system,” said U.S. Attorney David Gaouette. “When a patient sees a doctor, they need to know that the doctor is licensed, in good standing, and only submitting charges for medical services actually performed.”

“The Inspector General’s Office of the U.S. Department of Health and Human Services will continue to work closely with our state and federal law enforcement partners to protect the Medicare and Medicaid programs,” said Mike Fields, Special Agent in Charge of the agency’s Kansas City Region.

“An unlicensed individual practicing medicine as a doctor is unacceptable,” said FBI Special Agent in Charge James Davis. "Fraudulent billing schemes like these are all too commonplace and continue to increase the cost of health care. The FBI will continue to work with our federal, state, and local law enforcement partners to combat health care fraud.”

“The Medicaid programs in Colorado and other states provide essential health services to the neediest in our communities,” Attorney General John Suthers said. “Perpetrators of Medicaid fraud not only steal from the state, but they also reduce the level of services and assistance Colorado can provide to the poor and infirm. This case underlines our commitment to working in cooperation with our federal peers to vigorously investigate and prosecute instances of Medicaid fraud.”

Dilorom Asimova is charged with one count of conspiracy to commit health care fraud, 12 counts of health care fraud, and one count of making a false statement. Terry Gardner is charged with one count of conspiracy to commit health care fraud, 12 counts of health care fraud, and one count of making false statements in relation to a health care matter. If convicted of conspiracy to commit health care fraud, the defendants face not more than five years’ incarceration, and up to a $250,000 fine. If convicted of health care fraud, both defendants face not more than 10 years in federal prison, and a fine of up to $250,000, per count. If convicted of making a false statement, each defendant faces not more than five years' imprisonment, and up to a $250,000 fine.

This case was investigated by the Health and Human Services Office of the Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), and the Colorado Attorney General’s Office Medicaid Fraud Control Unit.

The defendants are being prosecuted by Assistant U.S. Attorney Jaime Pena.

The charges contained in the indictment are allegations, and the defendants are presumed innocent unless and until proven guilty.