Sherman Oaks Mastermind Of $20M Well being Care Fraud Pleads Responsible

LOS ANGELES, CA — A Sherman Oaks girl pleaded responsible Tuesday to federal prices for her management function in a fraud scheme by which greater than $20 million in bogus claims have been submitted to insurance coverage corporations.

Roshanak “Roxanne” Khadem, 54, and 4 others — together with a former fraud investigator at Anthem Blue Cross — have been charged in a multiyear conspiracy to commit well being care fraud towards not less than eight corporations, in response to the U.S. Legal professional’s Workplace.

She pleaded responsible in Los Angeles federal court docket to at least one depend every of well being care fraud and tax evasion. U.S. District Decide Stephen V. Wilson scheduled a June 27 sentencing listening to, at which era Khadem will withstand 13 years in federal jail.

Khadem owned and operated R&R Med Spa, situated in Valley Village till early 2016, and its successor firm, Nu-Me Aesthetic and Anti-Growing older Heart, which operated in Woodland Hills.

She and others induced sufferers to go to the clinics to obtain “free” beauty procedures, together with facials, laser hair removing and Botox injections which weren’t lined by insurance coverage.

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The conspirators obtained insurance coverage info from sufferers, utilizing it to invoice for pointless medical companies or for companies that have been by no means offered.

Khadem and her associates calculated a “credit score” that sufferers may use to obtain the “free” or discounted beauty procedures.

Throughout the course of the scheme, Khadem and different defendants submitted not less than $20 million in claims to Anthem and different insurance coverage corporations, which paid about $8 million on these claims, in response to the indictment filed in 2018.

The remaining 4 defendants every pleaded responsible.

In November, Gary Jizmejian, 48, of Santa Clarita, a former fraud investigator at Anthem, was sentenced to a 12 months and a half behind bars for his function.

The scheme defrauded, amongst different entities, the Worldwide Longshore and Warehouse Union, Pacific Maritime Affiliation Profit Plan, which is the well being profit plan that covers longshore employees in Southern California and their dependents, prosecutors mentioned. One other alleged sufferer was the Federal Workers Well being Advantages Program, which gives medical insurance for federal workers.

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