WASHINGTON—A Los Angeles physician
assistant who stole the identities of doctors to write medically unnecessary
prescriptions for expensive durable medical equipment (DME) and diagnostic
tests was sentenced today to serve 72 months in prison in connection with a
$18.9 million Medicare fraud scheme, announced the Department of Justice, FBI
and U.S. Department Health and Human Services (HHS).
David James Garrison, 50, was sentenced
by U.S. District Judge Consuelo B. Marshall in the Central District of
California. In addition to his prison term, Garrison was sentenced to three
years of supervised release and ordered to pay $24,935 in restitution, jointly
and severally with convicted co-defendants.
In June 2012, after a two-week trial, a
federal jury found Garrison guilty of one count of conspiracy to commit health
care fraud, six counts of health care fraud, and one count of aggravated
identity theft. The trial evidence showed that Garrison worked at fraudulent
medical clinics that operated as prescriptions mills and trafficked in
fraudulent prescriptions and orders for medically unnecessary DME and
diagnostic tests that were used by fraudulent DME supply companies and medical
testing facilities to defraud Medicare. Garrison wrote the prescriptions and
ordered the tests on behalf of doctors whom he never met and who did not
authorize him to write prescriptions and order tests on their behalf.
The trial evidence showed that between
March 2007 and September 2008, Garrison’s co-conspirator Edward Aslanyan and
others owned and operated several Los Angeles medical clinics established for
the sole purpose of defrauding Medicare. Aslanyan and others hired street-level
patient recruiters to find Medicare beneficiaries willing to provide the
recruiters with their Medicare billing information in exchange for expensive,
high-end power wheelchairs and other DME, which the patient recruiters told the
beneficiaries they would receive for free. Often, the solicited Medicare
beneficiaries did not have a legitimate medical need for the power wheelchairs
and equipment. The patient recruiters then provided the beneficiaries’ Medicare
billing information to Aslanyan and others or brought the beneficiaries to the
fraudulent medical clinics. In exchange for recruiting the Medicare
beneficiaries, Aslanyan and others paid the recruiters a cash kickback for
every beneficiary they recruited.
The evidence presented at trial showed
that Garrison wrote prescriptions for power wheelchairs, which the
beneficiaries did not need and did not use. In some cases, Garrison wrote power
wheelchair prescriptions for beneficiaries he never examined and who never
visited the clinics. Once Garrison wrote the power wheelchair prescriptions,
Aslanyan and others sold them from $1,000 to $1,500 to the owners and operators
of approximately 50 different fraudulent DME supply companies, which used the
prescriptions to submit fraudulent power wheelchair claims to Medicare. The DME
supply companies purchased the power wheelchairs wholesale for approximately
$900 per wheelchair but billed the wheelchairs to Medicare at a rate of
approximately $5,000 per wheelchair. Aslanyan also used the prescriptions
Garrison wrote at two fraudulent DME supply companies that Aslanyan owned and
operated.
In addition, the trial evidence showed
that Garrison ordered the same medically unnecessary diagnostic tests for every
Medicare beneficiary, including tests for sleep studies, ultrasounds and nerve
conduction. These tests were then billed to Medicare by fraudulent diagnostic
testing companies that paid Aslanyan kickbacks to operate from the medical
clinics.
The trial evidence showed that Garrison
admitted to writing prescriptions for power wheelchairs and ordered diagnostic tests
on behalf of approximately six different doctors, many of whom never met
Garrison and never had a delegation of services agreement with him, as required
by law. The trial evidence also showed that Garrison was paid up to $10,000 a
week in cash for his work at the clinics.
As a result of this fraud scheme,
Garrison and his co-conspirators submitted over $18.9 million in false claims
to Medicare and received $10.7 million on those claims.
Currently, Garrison is facing federal
drug charges as a result of his alleged involvement with another medical clinic
where medically unnecessary prescriptions for Oxycontin were distributed.
Garrison is scheduled for trial on the federal drug charges on November 6,
2012. He is presumed innocent of the charges against him.
Aslanyan pleaded guilty for his role in
the scheme in April 2011 and was sentenced on February 6, 2012, to 77 months in
prison. Carolyn Vasquez, another co-conspirator, pleaded guilty for her role in
the scheme in March 2011 and was sentenced on January 9, 2012, to 60 months in
prison.
Today’s sentence was announced by
Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S.
Attorney André Birotte Jr. for the Central District of California; Tony Sidley,
Assistant Chief of the California Department of Justice, Bureau of Medi-Cal
Fraud and Elder Abuse; Glenn R. Ferry, Special Agent in Charge for the Los
Angeles Region of the HHS Office of Inspector General (HHS-OIG); and Timothy
Delaney, Special Agent in Charge of the FBI’s Los Angeles Field Office.
The case is being prosecuted by Trial
Attorney Jonathan T. Baum of the Criminal Division’s Fraud Section and
Assistant U.S. Attorney David Kirman of the Central District of California. The
case is being investigated by the FBI and was brought as part of the Medicare
Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the
U.S. Attorney’s Office for the Central District of California.
Since its inception in March 2007,
strike force operations in nine locations have charged more than 1,330
defendants who collectively have billed the Medicare program for more than $4
billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working
in conjunction with the HHS-OIG, are taking steps to increase accountability and
decrease the presence of fraudulent providers.
To learn more about the Health Care
Fraud Prevention and Enforcement Action Team, go to: www.stopmedicarefraud.gov.
No comments:
Post a Comment