May 7, 2021 - A California woman was arrested Thursday in Los Angeles on criminal health care fraud charges arising from her false home health certifications and related fraudulent billings to Medicare.

According to court documents, Lilit Gagikovna Baltaian, 58, of Porter Ranch, operated two medical clinics in the Los Angeles area. From approximately January 2012 to July 2018, Baltaian allegedly falsely certified patients to receive home health care from at least four Los Angeles area home health agencies. Baltaian’s false certifications were used by the home health agencies to fraudulently bill Medicare for the unnecessary home health care. Baltaian allegedly received a cash benefit related to these referrals and also submitted claims to Medicare for signing the fraudulent certifications and for patient visits and injections that were not needed and/or provided.

As further alleged in court documents, between January 2012 and July 2018, four home health agencies used Baltaian’s false certifications to submit fraudulent claims to Medicare, resulting in a total of approximately $6,029,674 paid on those claims.

Baltaian is charged with four counts of health care fraud. If convicted, Baltaian faces a maximum penalty of 10 years in prison on each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division; Acting U.S. Attorney Tracy L. Wilkison of the Central District of California; Assistant Director in Charge Kristi Koons Johnson of the FBI’s Los Angeles Field Office; and Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Los Angeles Regional Office made the announcement.

The FBI and HHS-OIG are investigating the case, which was charged as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California.

The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program nearly $19 billion. 

Trial Attorney Emily Culbertson of the Criminal Division’s Fraud Section is prosecuting the case.

An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
Source: DOJ