A West Hollywood, California man has been found guilty of multiple charges involving a healthcare fraud scheme. Julian Omidi, 53, and his Beverly Hills-based company, Surgery Center Management LLC (SCM), carried out an elaborate scheme defrauding insurance companies including Tricare, Anthem Blue Cross, UnitedHealthcare, Aetna, and others. (I guess there will be no star on the Hollywood Walk of Fame for this deceptive guy.)
Omidi, a former doctor whose license was revoked in 2009, was the ringleader of this operation. He controlled SCM, a GET THIN entity. (GET THIN was basically created to promote Lap-Band weight-loss surgeries.) Omidi established procedures requiring prospective Lap-Band patients to have at least one sleep study (disregarding the complete lack of coverage by his patients’ insurance). He even incentivized his employees to push for these studies. (Omidi needed these sleep studies to convince the insurance companies to pre-approve the Lap-Band procedure.)
After sending his patients through the sleep studies, Omidi directed SCM employees to falsify the results among other important medical info. (It wasn’t even clear if the patients actually needed these sleep studies.) Omidi used the falsified results to support GET THIN’s pre-authorization requests for Lap-Band surgery. Insurance companies authorized payment for some of the proposed surgeries based on these false results. (GET THIN made a pretty penny with this scheme, coming in at an estimated $41 million for the Lap-Band procedures.)
Even in the worst-case scenario for Omidi, when an insurance company did not authorize the Lap-Band surgery, GET THIN still submitted bills for a whopping $15,000 per sleep study, totaling $27 million. (Don’t fret – the government eventually seized more than $110 million in funds and securities from Omidi and similar fraudsters.) Omidi set up various bank accounts to receive these insurance payments. (Total fraudulent billings were approximately $355 million.)
Justice was served, as Omidi and SCM were found guilty of (you might want to sit down for this) 28 counts of wire fraud, three counts of mail fraud, two counts of making false statements relating to health care matters, one count of aggravated identity theft, one count of conspiracy to commit money laundering, and two counts of money laundering. (Spoiler alert: This isn’t the only fraud company controlled by Omidi). His co-conspirator was Dr. Mirali Zarrabi, a 59-year-old from Beverly Hills. Zarrabi was acquitted of all charges. (I wonder if Dr. Zarrabi provided all the information investigators needed to seal Omidi’s fate? Seems like he got off pretty easy.)
Omidi has an important date on his calendar coming up. On April 6, 2022, he will attend his sentencing hearing, where he will face a statutory maximum sentence of 20 years in federal prison for each of the mail fraud, wire fraud, and money laundering counts and a mandatory consecutive two-year sentence for aggravated identity theft. (There’s no doubt that Omidi will not need any Lap Band surgery while incarcerated. I’ve heard that prison food leaves a lot to be desired.)
Today’s Fraud of the Day comes from a Department of Justice press release, “Former West Hollywood Doctor and Company Associated with 1-800-GET-THIN Guilty of Massive Fraud Against Health Insurers,” dated December 16, 2021.
LOS ANGELES – A former doctor and his company were found guilty today by a federal jury of scheming to defraud private insurance companies and the Tricare health care program for military service members by fraudulently submitting an estimated $355 million in claims related to the 1-800-GET-THIN Lap-Band surgery business.
Julian Omidi, 53, of West Hollywood, and an Omidi-controlled Beverly Hills-based company, Surgery Center Management LLC (SCM), were found guilty of 28 counts of wire fraud and three counts of mail fraud. Omidi also was found guilty of two counts of making false statements relating to health care matters, one count of aggravated identity theft and two counts of money laundering. Omidi and SCM were found guilty of one count of conspiracy to commit money laundering.