Two hospice fraud cases are moving forward in California and Arizona, states that some stakeholders consider to be potential hotbeds of malfeasance in the space.
Karen Sarkisyan, a.k.a. Kevin Sarkisyan, of San Gabriel Hospice & Palliative Care, pleaded guilty to one count of conspiracy to defraud the government for his involvement in submitting false enrollment applications to Medicare that hid the “real owners of a hospice company,” according to court documents.
Meanwhile, Dr. Nima Ghadimi, founder and president of the Scottsdale Physician Group (SPG), is reportedly under investigation for his potential involvement in health care fraud and kickback schemes.
False Claims Act violations in California
San Gabriel Hospice & Palliative Care submitted roughly $3.67 million in false and fraudulent claims to Medicare, of which $3.18 million paid after Sarkisyan submitted the false enrollment applications, court documents indicated.
Sarkisyan is accused of “falsely identifying a straw owner as the sole owner and manager, concealing the actual beneficial owners and managers,” according to the court reports.
The State of California’s Justice Department investigated the case with the FBI and the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG).
Tthe U.S. Justice Department last year indicted Sarkisyan and alleged co-conspirators False Claims Act violations, among other charges.
Sarkisyan was charged with conspiracy to commit wire fraud, wire fraud, conspiracy to commit health care fraud, health care fraud, conspiracy to commit money laundering, and money laundering.
He was also charged with theft of government property for illegally obtaing funds from the Paycheck Protection Program (PPP), established by the federal government during the COVID-19 public health emergency.
“The Criminal Division and our partners are committed to identifying and holding accountable those who exploit the COVID-19 pandemic for their own gain,” Assistant Attorney General Kenneth Polite, Jr., said in a statement. “As these cases demonstrate, we are unwavering in our determination to prosecute those who have defrauded relief programs meant to help struggling Americans during the pandemic.”
Co-conspirator Gayk Akhsharumov of San Gabriel, California, also pleaded guilty to health care fraud conspiracy and is scheduled to be sentenced later this year on Aug. 14. A third co-conspirator, Babken Chalkadryan, was indicted for his role in the scheme, but “remains a fugitive,” according to court reports/documents.
Fraud, kickback inquiries brewing in Arizona
In Arizona, OIG and U.S. Justice Department are reportedly investigating Dr. Nima Ghadimi, founder and president of the Scottsdale Physician Group (SPG), for potential involvement in health care fraud and kickback schemes.
Since 2016, the Arizona-based hospitalist physician group has provided hospice and palliative care at the HonorHealth Shea Medical Center.
Ghadimi is a suspected of up-coding Medicare billing claims, improper inpatient admissions and wrongful obtainment of PPP Loans, according to a local news report.
Reportedly, SPG may have submitted more than 15,000 false billing claims since 2016.
Ghadimi is accused of misusing Medicare payments. He is also under investigation for kickbacks. The physician allegedly siphoned millions into personal accounts over the course of several years, including some in his mother’s name, according to the Hertel Report.
Ghadimi filed for bankruptcy for SPG and its affiliate companies on March 2, 2022 to the tune of $589 million. Ghadimi disclosed in the bankruptcy report that SPG Hospice held $50,000 in assets and up to $500,000 in liabilities at the time of filing, among other debts.