A doctor from California, Lilit Gagikovna Baltaian, has admitted to participating in a massive Medicare fraud scheme, causing the government to lose over $1.4 million. This case highlights the serious consequences of health care fraud and the role of physicians in maintaining the integrity of the health care system.
Lilit Gagikovna Baltaian’s Role in the Fraudulent Medicare Scheme
Lilit Gagikovna Baltaian, a 61-year-old doctor from Porter Ranch, California, has pleaded guilty to charges of health care fraud. She was found to have knowingly signed false documents for home health care services that were not medically needed. Baltaian’s role in the scheme began in January 2012 and continued until July 2018.
As a licensed physician in California and a Medicare provider, Baltaian certified patients to receive home health care from multiple agencies in the Los Angeles area. However, these certifications were not based on real medical evaluations. In some cases, Baltaian didn’t even meet with the patients or conduct the required medical assessments. Instead, she signed blank, undated forms, leaving the home health agencies to fill in the details later to make it appear as though she had seen the patients and confirmed the need for the care.
These fake certifications allowed the home health agencies to submit fraudulent claims to Medicare. This resulted in the U.S. government being billed for unnecessary medical services that were never provided to the patients.
How the Fraud Worked
The fraudulent scheme involved at least four home health agencies in the Los Angeles area. These agencies used the false certifications from Baltaian to submit bogus claims to Medicare. In return, Baltaian received cash payments for her part in the fraud. Additionally, she also submitted claims to Medicare, pretending to have been paid for signing these fraudulent documents.
From January 2012 to July 2018, this scam caused Medicare to lose at least $1,449,050. The home health agencies received payments for services they never delivered, and Baltaian’s false certifications played a crucial role in making the fraud appear legitimate.
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By falsifying these documents and approving unnecessary home health care, Baltaian took advantage of the Medicare system, which is designed to help elderly and disabled individuals who genuinely need medical care. This dishonest behavior put millions of taxpayer dollars at risk and took resources away from people who truly needed help.
The Legal Consequences and Investigation
Baltaian has pleaded guilty to the charge of health care fraud, and her sentencing will take place on April 3, 2025. She faces up to 10 years in prison for her involvement in this scheme. A judge will decide the final sentence based on federal guidelines and other factors related to the case.
The investigation into this fraud was led by the FBI’s Los Angeles Field Office and the Department of Health and Human Services Office of Inspector General (HHS-OIG). Both agencies work together to investigate and prevent health care fraud, and this case is just one example of their ongoing efforts to protect Medicare funds.
The Department of Justice’s Criminal Division is prosecuting the case. Assistant Attorney General Nicole M. Argentieri and other officials from the FBI and HHS-OIG announced the guilty plea, emphasizing that these types of crimes undermine public trust in the health care system.
This case is also part of a larger effort by the Justice Department to fight health care fraud. Since 2007, the Health Care Fraud Strike Force has charged over 5,400 people for defrauding Medicare and other health programs, totaling more than $27 billion in false claims. The strike force aims to ensure that health care providers are held accountable for their actions, especially when they harm patients and waste taxpayer money.
The fraudulent behavior of Baltaian and the home health agencies involved serves as a reminder of the importance of maintaining honesty and integrity in the medical field. Medicare is a vital program for millions of people, and its resources should be used responsibly to ensure that those who need help receive it.