Clinic operator charged with health care fraud

Clinic operator charged with health care fraud

BY TONY CASTRO, Staff Writer
LA Daily News Article Last Updated:11/10/2006 09:27:19 PM PST

A Russian immigrant living in Agoura Hills has been charged with bilking
Medicare out of more than $1.4 million in an elaborate scam in which he used
Mother Teresa’s personal physician to prey on homeless patients from Skid Row.
Rudik Avakyan, 55, in jail on $1.1 million bail, faces arraignment Monday on
charges that he recruited Medi-Cal and Medicare card holders at Los
Angeles’s Union Rescue Mission for fraudulent billing at a clinic he owned and
operated.
According to authorities, the clinic’s medical director – Dr. Prasantha
Nath, who once counted the late Mother Teresa among his patients – was an
unwitting participant in the scam that included the fraudulent reporting of medical
services that were never provided and billing for services provided to
patients who were dead.
Nath is not a defendant in the case, authorities said, and, in fact, was a
victim of identity theft in the scam.
Nath worked at Avakyan’s clinic two or three days a week – and only for a
few weeks before quitting – treating a handful of patients each day, a state
Attorney General’s investigation found.
But authorities say that Avakyan’s clinic fraudulently submitted claims for
hundreds of patients that Nath "could not possibly have treated, padded
Medicare bills with treatments that never occurred, submitted bills for services
rendered to 35 patients who were already deceased, and filled out medical
treatment charts for patients as much as six months prior to them actually being
seen by a doctor."
Avakyan and two co-defendants also went so far as to bill Medicare for
treatments that Nath purportedly provided patients while he was out of the country
helping tsunami victims in Sri Lanka and the needy in India, according to
investigators.
Nath’s physician provider number was used for Medicare billings several
month past the time he had left the clinic, authorities said.
Avakyan was arrested last week at his home by agents from the Attorney
General’s Bureau of Medi-Cal Fraud and Elder Abuse.
His co-defendants, Gayane Abramyan, 44, and Lusine Khatchatryan, were
described by authorities as "purported medical assistants at the Workplace
Industrial Management Clinic in Los Angeles."
The three are charged with a felony complaint alleging 37 counts of grand
theft, attempted grand theft and filing of false claims.
Bail was set at $100,000 each for both Abramyan and Khatchatryan.
Prosecutors also succeeded in attaching a motion to Avakyan’s bail that
would require him to prove that the money he uses to post bail did not come from
the proceeds of the alleged crime.
Attorneys for the defendants could not be reached for comment.
According to authorities, the scam began unraveling in the summer of 2005
when officials from the Union Rescue Mission reported the suspicious
recruitment of the homeless by so-called "cappers" who would regularly round up Skid
Row residents into vans with promises of free meals and a $50 cash payment.
Avakyan and his defendants would then pay the cappers $350 for each patient
they brought to his clinic, authorities said.
Assembly Speaker Fabian Nu ez, D-Los Angeles, whose office received report
of the suspicious recruitment of the homeless in Skid Row, called for "the
harshest penalties allowed by law."
"We cannot tolerate this kind of fraud," Nu ez said in a statement, "I am
pleased by the hard work done by the Attorney General’s Office to unravel this
ring of rip-off artists."
In announcing the arrests, Attorney General Bill Lockyer said "these
defendants must be held accountable for allowing their greed to turn to fraud."
"Medicare and Medi-Cal fraud not only rips off taxpayers," he said, "it also
puts public health at risk by limiting the amount of resources available to
help those truly in need."
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