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California woman charged in alleged $6M Medicare fraud scam

May 10, 2021 GMT

WOODLAND HILLS, Calif. (AP) — A Southern California woman faces criminal charges after she created fake home health care certifications leading to more than $6 million in fraudulent Medicare billings, federal authorities said.

Lilit Gagikovna Baltaian, 58, of Porter Ranch, was arrested Thursday after authorities said she fraudulently certified patients to receive care from four separate home health agencies — two in Glendale and two in Panorama City — between January 2012 to July 2018, the Daily News reported.

Police said the agencies would then file claims for reimbursement with Medicare for services that were not provided or unnecessary, and Baltaian would receive cash benefits from the home health agencies for the referrals. Authorities said Baltaian also submitted her own claims for reimbursement.

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It was not immediately known if Baltaian had an attorney to speak on her behalf.

Physicians, registered nurses or qualified therapists can certify patients for home care from home health agencies if they are confined to their home because of illness or injury. The agencies file claims with Medicare for reimbursement.

Home health services could include changing wound dressings, giving injections or teaching patients’ family members to properly care for their loved one.

Prosecutors claim Baltaian and the home health agencies knew the certifications were false, or not necessary, before the agencies submitted claims to Medicare. Baltaian faces four charges of health care fraud and could receive up to 40 years in prison if convicted.

It was not immediately known how many claims were submitted by the agencies or if the agencies could face charges for their alleged involvement in the fraudulent scheme.