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Wednesday, June 2, 2021

Seal Beach physician pleads guilty to role in Medicaid fraud conspiracy - OCRegister

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A Seal Beach doctor pleaded guilty Wednesday to conspiring to commit health care fraud, admitting to his role in a multi-million dollar scheme.

Keyvan Amirikhorheh, 61, was the last of five defendants to admit to defrauding Medicaid by submitting fraudulent health claims related to family planning services, diagnostic testing and prescriptions, according to the United States Department of Justice.

Prosecutors allege that between March 2016 and April 2019, the Los Angeles Community Clinic – where Amirikhorheh worked as a physician – and related laboratories and pharmacies submitted nearly $8.5 million in fraudulent claims to Medi-Cal and were paid more than $6.5 million.

According to Amirikhorheh’s written plea deal, he and the other defendants created false patient names and charts, as well as fake “vital sign readings like blood pressure, weight and height,” in order to submit false claims to Medi-Cal’s Family Planning, Access, Care and Treatment program. The program was meant to provide family planning services to low-income California residents, according to court filings.

As part of the plea deal, Amirikhorheh admitted to being directly responsible for approximately 37.4 percent of the fraudulent claims included in the scheme. That corresponds to a little more than $2 million worth of medical claims, according to the plea deal.

Amirikhorheh is scheduled to return to court for sentencing on Oct. 1. He faces up to 10 years in prison.

Amirikhorheh and his co-defendants were charged as part of a wider wave of health care fraud cases that targeted more than 30 people across the West Coast and included an estimated $258 million in Medicare and Medicaid Fraud. That large-scale investigation into fraudulent medical billings was coordinated by the Department of Justice’s Health Care Fraud Unit and carried out by a Medicare Fraud Strike Force comprised of investigators from a variety of federal law enforcement agencies.

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Seal Beach physician pleads guilty to role in Medicaid fraud conspiracy - OCRegister
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