Health spa owner pleads guilty to $20-million fraud scheme – Los Angeles Times

The former owner of a group of health spas and clinics in the San Fernando Valley pleaded guilty Tuesday to her role in a $20-million healthcare fraud scheme that involved Botox injections and laser hair removal, according to federal investigators.

Patients at the health spas and clinics were asked to hand over their insurance information, even though the staff and owner knew the cosmetic procedures would not be covered by the patients’ insurance providers.

Roshanak Khadem, 54, also known as “Roxy” and “Roxanne,” arranged the scheme and submitted over $20 million in false claims along with four other co-defendants, according to federal prosecutors.

On Tuesday, Khadem pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of subscribing to a false income tax return, according to federal prosecutors.

A former senior investigator with Anthem Blue Cross, Gary Jizmejian, was sentenced to a year and a half in federal prison in November for his role in the scheme.

Federal investigators say Jizmejian, 48, received quarterly payments from the clinic operators ranging from $1,000 to $2,500 for information on Anthem’s claims process. He also notified his co-defendants of the federal probe into the scheme, according to court records.

Lucine Ilangezyan, 42, of North Hills, worked as an insurance biller and pleaded guilty to one count of conspiracy to commit health fraud and was sentenced to 18 months in prison. Dr. Roberto Mariano, 63, of Rancho Cucamonga, who helped operate the clinics, and office manager Marina Sarkisyan, 52, of Panorama City, also pleaded guilty, and both await sentencing, according to prosecutors.

From January 2012 to at least April 2016, patients received cosmetic procedures that the defendants knew were not covered by insurance. But staff at the clinics explained to the patients they could get “free” or discounted cosmetic procedures based on “credit” they would earn. The insurance information was then used to file false claims. A portion of the payout from the insurance companies would then be calculated for the “credit” that the patients could use at the clinics, according to prosecutors.

In court documents, tests and procedures fraudulently billed to insurance companies ranged from office visits to “nerve conduction tests” and something labeled “flourescent [sic] antibody; titer.”

Proceeds from the fraudulent claims were deposited into bank accounts held in the names of doctors hired part-time at the clinics, but Khadem, a Sherman Oaks resident, had signatory authority over the accounts and she was able to withdraw money using pre-signed checks she received from the doctors, according to court documents.

Khadem’s scheme defrauded several insurance providers, including the Federal Employees Health Benefits Program, which provides health insurance for federal employees. Plans that provide health insurance to longshore workers in Southern California and their dependents also were victim to the scheme, prosecutors said.

Khadem also did not report any of this income on her tax returns from 2013 to 2015, and the underreporting totals a tax loss of over $450,000, according to prosecutors. At her June sentencing, she faces up to 13 years in prison.