Two Doctors Arrested Pursuant to Federal Indictment That Alleges Bogus Sleep Studies Helped 1-800-GET-THIN Fraudulently Bill Insurance Programs Over $250 Million Related to Lap-Band Surgeries
Two doctors were arrested this morning on federal fraud charges stemming from more than
Two corporations controlled, in part, by Omidi -
The indictment contains charges of mail fraud, wire fraud, false statements, money laundering and aggravated identity theft.
Omidi, a physician whose license was revoked in 2009, controlled, in part, the GET THIN network of entities, including SCM and IMS, that focused on the promotion and performance of elective, Lap-Band weight-loss surgeries. Omidi 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 - a "co-morbidity," such as sleep apnea - that GET THIN would use to convince the patient's insurance company to pre-approve the Lap-Band procedure.
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, allegedly often falsified the results to reflect that the patient had moderate or severe sleep apnea, and that they suffered from severe daytime sleepiness. Omidi then caused those falsified sleep study reports to be used in support of GET THIN's pre-authorization requests for Lap-Band surgery.
Relying on the false sleep studies - as well as other false information, including patients' heights and weights - insurance companies authorized payment for some of the proposed Lap-Band surgeries. The indictment alleges that GET THIN received at least
Even if the insurance company did not authorize the surgery, GET THIN still was able to submit bills for approximately
The victim health care benefit programs include TriCare,
"The scheme outlined in the indictment focuses on bogus sleep studies that the defendants utilized to engage in a much more lucrative fraud involving Lap-Band procedures," said Acting United States Attorney
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.
"While the defendants in this case were scheming victims who had hopes of 'getting thin,' they were also busy getting rich by defrauding the insurance companies and exploiting unwitting victims in many cases," said
"The
"Doctor Zarrabi and former physician Omidi victimized countless patients when they allegedly provided medically unnecessary treatment in order to boost their own profits to the tune of tens of millions of dollars," said California Insurance Commissioner
In 2014, the government seized more than
"Driven by greed, Omidi and Zarrabi allegedly sought to cheat their way to riches by bilking millions of dollars from Tricare and other health care providers," stated
Omidi and Zarrabi, along with the corporate defendants, are scheduled to be arraigned on the indictment this afternoon in
An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty in court.
If they were to be convicted in this case, Omidi and Zarrabi potentially would face decades in federal prison, including a statutory maximum penalty of 20 years in prison for each of the 31 mail fraud and wire fraud counts alleged in the indictment.
This case is the product of an investigation by the
The GET THIN case is being prosecuted by Assistant United States Attorneys
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