San Francisco, CA (WorkersCompensation.com) - The Division of Workers' Compensation (DWC) has suspended 11 more medical providers from participating in California's workers' compensation system, bringing the total number of providers suspended to 177. The providers were suspended for fraud or other criminal actions, or the loss of their license.
DWC Administrative Director George Parisotto issued suspension orders against the following providers:
• Edward Aslanyan, Armen Shagoyen and Carolyn Vasquez, Van Nuys businesspersons, were convicted in federal court for conspiracy to defraud Medicare through their medical clinics and durable medical equipment companies in Los Angeles County. As a result of their fraudulent scheme, Medicare was defrauded between approximately $2.5 million and $13.6 million. Aslanyan was sentenced to federal prison for 77 months and ordered to pay more than $10 million in restitution. Shagoyen was sentenced to federal prison for 12 months and 1 day. Vasquez was sentenced to federal prison for 60 months and ordered to pay more than $6 million in restitution.
• Sharon Patrow and Priscilla Villabroza, operators and co-owners of California Hospice Care, LLC, in Covina were convicted in federal court in 2015 and 2016, respectively, of health care fraud for a scheme to defraud Medicare and Medi-Cal. Patrow and Villabroza concealed the fact that Villabroza had been convicted of fraud on a government program when submitting a Medicare provider application. Patrow and Villabroza also paid illegal kickbacks in exchange for recruited beneficiaries and paid physicians to falsely certify that beneficiaries were terminally ill and needed hospice services. Villabroza was sentenced to 54 months in federal prison and ordered to pay more than $5 million in restitution. Patrow was sentenced to five years of probation and ordered to pay more than $7 million in restitution.
o Erwin Castillo, Los Angeles registered nurse, was the director of nursing for Patrow and Villabroza's California Hospice Care facility. Castillo was convicted in federal court for conspiring to defraud Medicare and Medi-Cal and to obtain money from Medicare and Medi-Cal by false or fraudulent pretenses. Castillo and his co-conspirators submitted false and fraudulent claims to Medicare of approximately $6.8 million and Medi-Cal of $1.9 million. He was sentenced to 27 months in federal prison and ordered to pay more than $7 million in restitution.
o Nancy Briones, Adelanto registered nurse at California Hospice Care, was convicted in federal court in 2015 of health care fraud for deceiving Medicare and Medi-Cal by falsifying medical records of beneficiaries to make it appear that they were terminally ill. Briones was sentenced to federal prison for 18 months and ordered to pay approximately $3 million in restitution.
• The following provider participated in an illegal prescription mill that generated OxyContin prescriptions that the clinic's patients did not need and submitted claims to Medicare and Medi-Cal for services that were medically unnecessary, not ordered by a doctor and/or not performed:
o Elza Budagova of Fort Worth, Texas, was convicted in federal court in 2014 of conspiracy to distribute controlled substances. Budagova worked at a Los Angeles clinic operated by Mike Mikaelian and Anjelika Sanamian, who were convicted in federal court in 2014 and 2015, respectively, of conspiracy to commit health care fraud, conspiracy to distribute controlled substances and money laundering. The clinic, together with its doctors, fraudulently billed Medicare approximately $4.6 million and Medi-Cal approximately $1.6 million for medical services. Budagova acted as an unlicensed physician's assistant, fabricated information in patient medical charts and wrote or signed prescriptions for OxyContin for patients who never actually visited the clinic. She was sentenced to 36 months in federal prison and ordered to pay more than $1 million in restitution.
• The following providers were suspended because their licenses were suspended, surrendered or revoked:
o Ji Hae Kim, Fullerton nurse, was convicted in federal court in 2012 of conspiracy to commit health care fraud for preparing false Medicare forms for beneficiaries receiving home health services. Kim worked for Greatcare Home Health, Inc., owned by Hee Jung “Angela” Mun, who pled guilty in federal court in 2012 to health care fraud. Kim's registered nursing license was revoked in 2014.
o Gregory Antkowiak, San Diego physician, surrendered his medical license in 2017 after being placed on probation for gross negligence by the Medical Board of California.
o Edmond Clinton, Pasadena physician, surrendered his medical license to the Medical Board of California in 2017 after he was accused of gross negligence when he kissed a patient on the lips without her consent, and failure to maintain adequate medical records.
AB 1244, which went into effect January 1, 2017, requires DWC's Administrative Director to suspend any medical provider, physician or practitioner from participating in the workers' compensation system in cases in which: • The provider has been convicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers' compensation system, fraud or abuse of a patient, or related types of misconduct; • The provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or • The provider's license or certificate to provide health care has been surrendered or revoked. The Department of Industrial Relation's (DIR's) fraud prevention efforts are posted online, including frequently updated lists for physicians, practitioners, and providers who have been issued notices of suspension, those who have been suspended pursuant to Labor Code §139.21(a)(1), and information on lien consolidations and the Special Adjudication Unit.
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