June 22, 2018
Two Iranian-American physicians have been indicted in California for defrauding insurers with fake filings from their weight loss firm.
Federal prosecutors said they defrauded insurance firms and patients of a quarter billion dollars over six years.
Their firm, Get Thin Lap-Band, has been a major advertiser on billboards across southern California.
Julian Omidi, 49, of West Hollywood, and Mirali Zarrabi, 55, of Beverly Hills, were arrested February 28 pursuant to the federal indictment that alleges a host of criminal charges between May 2010 and March 2016.
The indictment includes charges of mail fraud, wire fraud, false statements, money laundering and aggravated identity theft.
The indictment says Omidi, whose medical license was revoked in 2009, established procedures requiring prospective Lap-Band patients – even those covered by insurance plans he knew would never cover Lap-Band surgery – to have at least one sleep study, and employees were incentivized with commissions to make sure the studies occurred, according to the indictment.
The purpose of the sleep studies was to find a second reason–such as sleep apnea – that Get Thin would use to convince the patient’s insurance company to pre-approve the Lap-Band procedure.
The indictment says that after patients underwent sleep studies – often with little indication that any doctor had ever determined the study was medically necessary – Get Thin employees, acting at Omidi’s direction, often falsified the results to reflect that the patient had sleep apnea and suffered from severe daytime sleepiness. The firm used those falsified sleep study reports in support of Get Thin’s requests for Lap-Band surgery insurance payments.
Even if the insurance company did not authorize the surgery, Get Thin still was able to submit bills for approximately $15,000 for each sleep study, receiving millions of dollars in payments for these claims, according to the indictment.
Zarrabi allowed his electronic signature to be used by Get Thin to make it falsely appear that he had reviewed and interpreted the falsified sleep studies, even though he knew the reports were being altered, according to the indictment.
Zarrabi also allegedly demanded to be paid for the use of his electronic signature on hundreds of prescriptions for devices to treat sleep apnea. Zarrabi allegedly did not review the prescriptions, which were sent with the falsified sleep study reports to durable medical equipment providers that billed for sleep apnea equipment that patients often did not need.
Omidi and Zarrabi potentially face a maximum penalty of 20 years in prison for each of the 31 mail fraud and wire fraud counts alleged in the indictment.
