Monday, April 1, 2024

Two Men Sentenced for Role in $9M Hospice Fraud Scheme

 

The owner of two California-based hospice companies, along with his biller and consultant, were sentenced for their respective roles in a scheme that resulted in stealing over $9 million from Medicare in false and fraudulent claims for hospice services.

Gayk Akhsharumov, 40, of Glendale, California, the manager and beneficial owner of San Gabriel Hospice and Palliative Care Inc. (San Gabriel) and Broadway Hospice Inc., was sentenced to one year and one day in prison and ordered to pay $9,185,211 in restitution. Akhsharumov’s biller and consultant, Karen Sarkisyan, also known as Kevin Sarkisyan, 45, also of Glendale, was sentenced to one year and one day in prison and ordered to pay $3,688,050 in restitution.

According to court documents, from around January 2018 through May 2021, Akhsharumov used his two hospice companies to defraud Medicare of approximately $9 million. During the scheme, Akhsharumov concealed his ownership and control over the hospice entities from Medicare, inserted nominee owners, paid kickbacks to patient recruiters, and profited from the scheme. In April 2020, after San Gabriel had ceased operations, Akhsharumov used the company to fraudulently obtain COVID-19 relief funds. Akhsharumov submitted or caused the submission of fraudulent loan applications to the Small Business Administration for an Economic Injury Disaster Loan and to a financial institution for a Paycheck Protection Program loan, for which San Gabriel received $50,000. He also stole approximately $91,483 in funds deposited into San Gabriel’s bank account through the Provider Relief Fund program, a Department of Health and Human Services program that was intended to rapidly distribute pandemic-related funding to health care providers that met certain criteria. 

During the scheme, Sarkisyan submitted false and fraudulent Medicare enrollment forms for San Gabriel, falsely identifying a straw owner as the sole owner and manager and concealing the actual owners and managers. As a result, San Gabriel submitted false and fraudulent claims to Medicare, which resulted in Medicare paying approximately $3,668,050 to San Gabriel, of which $3,180,677 was paid after Sarkisyan submitted the false enrollment applications.

Akhsharumov pleaded guilty on March 13, 2023, to conspiracy to commit health care fraud. Sarkisyan pleaded guilty on April 3, 2023, to conspiracy to defraud the United States.

Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division; U.S. Attorney Martin Estrada for the Central District of California; Special Agent in Charge Timothy B. DeFrancesca of the Department of Health and Human Services Office of Inspector General (HHS-OIG); Assistant Director Michael D. Nordwall of the FBI’s Criminal Investigative Division; and Acting Assistant Director in Charge Amir Ehsaei of the FBI Los Angeles Field Office made the announcement.

HHS-OIG and the FBI Los Angeles Field Office investigated the case.

Assistant Chief Niall M. O’Donnell and Trial Attorney Patrick J. Queenan of the Criminal Division’s Fraud Section prosecuted the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, the program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.

No comments:

Post a Comment