Los Angeles Physician Assistant Found Guilty for Role in $18.9 Million Medicare Fraud Scheme
WASHINGTON – A Los Angeles physician assistant who worked at fraudulent medical clinics where he used the stolen identities of doctors to write prescriptions for medically-unnecessary durable medical equipment (DME) and diagnostic tests has been convicted of conspiracy, health care fraud and aggravated identity theft charges in connection with a $18.9 million Medicare fraud scheme, announced the Department of Justice, FBI and U.S. Department Health and Human Services (HHS).
On June 1, 2012, after a two-week trial in federal court in Los Angeles, a jury found David James Garrison, 50, guilty of one count of conspiracy to commit health care fraud, six counts of health care fraud and one count of aggravated identity theft. The trial evidence showed that Garrison worked at fraudulent medical clinics that operated as prescriptions mills and trafficked in fraudulent prescriptions and orders for medically-unnecessary power wheelchairs, DME and diagnostic tests that were used by fraudulent DME supply companies and medical testing facilities to defraud Medicare. Garrison wrote the prescriptions and ordered the tests on behalf of doctors whom he never met and who did not authorize him to write prescriptions and order tests on their behalf.
The trial evidence showed that between March 2007 and September 2008, Garrison’s co-conspirator, Edward Aslanyan, and others owned and operated several Los Angeles medical clinics established for the sole purpose of defrauding Medicare. Aslanyan and others hired street-level patient recruiters to find Medicare beneficiaries willing to provide the recruiters with their Medicare billing information in exchange for expensive, high-end power wheelchairs and other DME, which the patient recruiters told the beneficiaries they would receive for free. Often, the solicited Medicare beneficiaries did not have a legitimate medical need for the power wheelchairs and equipment. The patient recruiters then provided the beneficiaries’ Medicare billing information to Aslanyan and others or brought the beneficiaries to the fraudulent medical clinics. In exchange for recruiting the Medicare beneficiaries, Aslanyan and others paid the recruiters a cash kickback for every beneficiary they recruited.
Many of the beneficiaries whose Medicare billing information was used at the medical clinics lived hundreds of miles from the clinics, including some beneficiaries who lived over 300 miles from the clinics. One witness testified that the clinics used beneficiaries who lived such long distances from the clinics because the Medicare billing numbers of Medicare beneficiaries who lived in and around Los Angeles had been used in other Medicare fraud schemes and, therefore, could no longer be used to bill Medicare.
The evidence presented at trial showed that Garrison wrote prescriptions for power wheelchairs, which the beneficiaries did not need and did not use. In some cases, Garrison wrote power wheelchair prescriptions for beneficiaries he never examined and who never visited the clinics and, in one instance, prescribed a power wheelchair to a beneficiary who the evidence showed suffered from a mental defect and did not have the mental capacity to operate a power wheelchair. Several Medicare beneficiaries testified that they were approached by patient recruiters who convinced them to accept free power wheelchairs, but that they never went to the medical clinics and were never examined by Garrison.
Once Garrison wrote the power wheelchair prescriptions, Aslanyan and others sold them from $1,000 to $1,500 to the owners and operators of approximately 50 different fraudulent DME supply companies, which used the prescriptions to submit fraudulent power wheelchair claims to Medicare. The DME supply companies purchased the power wheelchairs wholesale for approximately $900 per wheelchair but billed the wheelchairs to Medicare at a rate of approximately $5,000 per wheelchair. Aslanyan also used the prescriptions Garrison wrote at Vila Medical and Blanc Medical Supply, another fraudulent DME supply company that Aslanyan owned and operated. When the owners and operators of the DME supply companies complained to Aslanyan and others about Garrison’s prescriptions looking the same, witness testimony established that Garrison changed the signature he used on the prescriptions.
In addition, the trial evidence showed that Garrison ordered the same medically-unnecessary diagnostic tests for every Medicare beneficiary, including tests for sleep studies, ultrasounds and nerve conduction. These tests were then billed to Medicare by fraudulent diagnostic testing companies that paid Aslanyan kickbacks to operate from the medical clinics.
Throughout the trial, evidence was introduced that showed that Garrison had admitted to writing prescriptions for power wheelchairs and ordered diagnostic tests on behalf of approximately six different doctors, and that he did not have a Delegation of Services Agreement with at least two of these doctors, as required by law.
As a result of this fraud scheme, Garrison, Aslanyan, and their co-conspirators submitted and caused the submission of over $18 million in false and fraudulent claims to Medicare, and received $10.7 million on those claims.
At sentencing, scheduled for Sept. 17, 2012, Garrison faces a maximum penalty of 72 years in prison and a $2 million fine. The aggravated identity theft conviction carries a mandatory two year prison sentence. In 2009 and 2010, Garrison was convicted on state charges of tax evasion and felonious possession of a firearm. Currently, Garrison is facing federal drug charges as a result of his alleged involvement with another medical clinic where medically-unnecessary prescriptions for Oxycontin were distributed. Garrison is scheduled for trial on the federal drug charges on Nov. 6, 2012. He is presumed innocent of the charges against him.
The jury’s verdict was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney André Birotte Jr. for the Central District of California; Tony Sidley, Assistant Chief of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse; Glenn R. Ferry, Special Agent-in-Charge for the Los Angeles Region of the HHS Office of Inspector General (HHS-OIG); and Steven Martinez, Assistant Director in Charge of the FBI’s Los Angeles Field Office.
The case is being prosecuted by Trial Attorney Jonathan T. Baum of the Criminal Division’s Fraud Section and Assistant U.S. Attorney David Kirman of the Central District of California. The case is being investigated by the FBI.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
Since their inception in March 2007, strike force operations in nine districts have charged 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about HEAT, go to: www.stopmedicarefraud.gov.