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California doctor admits guilt in Medicare fraud case

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Friday, November 22, 2024

California doctor admits guilt in Medicare fraud case

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Lisa O. Monaco Deputy Attorney General | Official Website

A California physician has admitted guilt in a Medicare fraud case involving false home health certifications and fraudulent billings. Lilit Gagikovna Baltaian, 61, from Porter Ranch, was licensed to practice medicine in California and was an enrolled Medicare provider. According to court documents, between January 2012 and July 2018, Baltaian falsely certified patients for home health care services through at least four Los Angeles area agencies. These certifications were used by the agencies to bill Medicare for unnecessary services.

Baltaian reportedly pre-signed blank certification forms, allowing agencies to falsify them later as if she had examined the patients and found clinical reasons for their need for home health care. She received cash benefits from these referrals and submitted claims to Medicare for signing the fraudulent certifications.

The fraudulent activities led to a loss of at least $1,449,050 to Medicare during this period. Baltaian has pleaded guilty to health care fraud and is set for sentencing on April 3, 2025. She could face up to ten years in prison, with the final sentence determined by a federal district court judge based on U.S. Sentencing Guidelines and other factors.

The announcement came from Principal Deputy Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division; Akil Davis, Assistant Director in Charge of the FBI Los Angeles Field Office; and Timothy B. DeFrancesca, Special Agent in Charge of HHS-OIG’s Los Angeles Regional Office.

The investigation is being conducted by the FBI and HHS-OIG. The case is prosecuted by Trial Attorneys Matthew Belz and Eric Schmale from the Criminal Division’s Fraud Section.

The Fraud Section's Health Care Fraud Strike Force Program leads efforts against health care fraud across nine strike forces operating in 27 federal districts since March 2007. This program has charged over 5,400 defendants who have collectively billed more than $27 billion from federal programs and private insurers. The Centers for Medicare & Medicaid Services are working with HHS-OIG to hold providers accountable for involvement in such schemes.

More information about these efforts can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.

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