Los Angeles Physician Assistant Sentenced to 72 Months in Prison for Role in $18.9 Million Medicare Fraud Scheme

WASHINGTON—A Los Angeles physicianassistant who stole the identities of doctors to write medically unnecessaryprescriptions for expensive durable medical equipment (DME) and diagnostictests was sentenced today to serve 72 months in prison in connection with a$18.9 million Medicare fraud scheme, announced the Department of Justice, FBIand U.S. Department Health and Human Services (HHS).
David James Garrison, 50, was sentencedby U.S. District Judge Consuelo B. Marshall in the Central District ofCalifornia. In addition to his prison term, Garrison was sentenced to threeyears of supervised release and ordered to pay $24,935 in restitution, jointlyand severally with convicted co-defendants.
In June 2012, after a two-week trial, afederal jury found Garrison guilty of one count of conspiracy to commit healthcare fraud, six counts of health care fraud, and one count of aggravatedidentity theft. The trial evidence showed that Garrison worked at fraudulentmedical clinics that operated as prescriptions mills and trafficked infraudulent prescriptions and orders for medically unnecessary DME anddiagnostic tests that were used by fraudulent DME supply companies and medicaltesting facilities to defraud Medicare. Garrison wrote the prescriptions andordered the tests on behalf of doctors whom he never met and who did notauthorize him to write prescriptions and order tests on their behalf.
The trial evidence showed that betweenMarch 2007 and September 2008, Garrison’s co-conspirator Edward Aslanyan andothers owned and operated several Los Angeles medical clinics established forthe sole purpose of defrauding Medicare. Aslanyan and others hired street-levelpatient recruiters to find Medicare beneficiaries willing to provide therecruiters with their Medicare billing information in exchange for expensive,high-end power wheelchairs and other DME, which the patient recruiters told thebeneficiaries they would receive for free. Often, the solicited Medicarebeneficiaries did not have a legitimate medical need for the power wheelchairsand equipment. The patient recruiters then provided the beneficiaries’ Medicarebilling information to Aslanyan and others or brought the beneficiaries to thefraudulent medical clinics. In exchange for recruiting the Medicarebeneficiaries, Aslanyan and others paid the recruiters a cash kickback forevery beneficiary they recruited.
The evidence presented at trial showedthat Garrison wrote prescriptions for power wheelchairs, which thebeneficiaries did not need and did not use. In some cases, Garrison wrote powerwheelchair prescriptions for beneficiaries he never examined and who nevervisited the clinics. Once Garrison wrote the power wheelchair prescriptions,Aslanyan and others sold them from $1,000 to $1,500 to the owners and operatorsof approximately 50 different fraudulent DME supply companies, which used theprescriptions to submit fraudulent power wheelchair claims to Medicare. The DMEsupply companies purchased the power wheelchairs wholesale for approximately$900 per wheelchair but billed the wheelchairs to Medicare at a rate ofapproximately $5,000 per wheelchair. Aslanyan also used the prescriptionsGarrison wrote at two fraudulent DME supply companies that Aslanyan owned andoperated.
In addition, the trial evidence showedthat Garrison ordered the same medically unnecessary diagnostic tests for everyMedicare beneficiary, including tests for sleep studies, ultrasounds and nerveconduction. These tests were then billed to Medicare by fraudulent diagnostictesting companies that paid Aslanyan kickbacks to operate from the medicalclinics.
The trial evidence showed that Garrisonadmitted to writing prescriptions for power wheelchairs and ordered diagnostic testson behalf of approximately six different doctors, many of whom never metGarrison and never had a delegation of services agreement with him, as requiredby law. The trial evidence also showed that Garrison was paid up to $10,000 aweek in cash for his work at the clinics.
As a result of this fraud scheme,Garrison and his co-conspirators submitted over $18.9 million in false claimsto Medicare and received $10.7 million on those claims.
Currently, Garrison is facing federaldrug charges as a result of his alleged involvement with another medical clinicwhere medically unnecessary prescriptions for Oxycontin were distributed.Garrison is scheduled for trial on the federal drug charges on November 6,2012. He is presumed innocent of the charges against him.
Aslanyan pleaded guilty for his role inthe scheme in April 2011 and was sentenced on February 6, 2012, to 77 months inprison. Carolyn Vasquez, another co-conspirator, pleaded guilty for her role inthe scheme in March 2011 and was sentenced on January 9, 2012, to 60 months inprison.
Today’s sentence was announced byAssistant 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-CalFraud and Elder Abuse; Glenn R. Ferry, Special Agent in Charge for the LosAngeles Region of the HHS Office of Inspector General (HHS-OIG); and TimothyDelaney, Special Agent in Charge of the FBI’s Los Angeles Field Office.
The case is being prosecuted by TrialAttorney Jonathan T. Baum of the Criminal Division’s Fraud Section andAssistant U.S. Attorney David Kirman of the Central District of California. Thecase is being investigated by the FBI and was brought as part of the MedicareFraud Strike Force, supervised by the Criminal Division’s Fraud Section and theU.S. Attorney’s Office for the Central District of California.
Since its inception in March 2007,strike force operations in nine locations have charged more than 1,330defendants who collectively have billed the Medicare program for more than $4billion. In addition, HHS’s Centers for Medicare and Medicaid Services, workingin conjunction with the HHS-OIG, are taking steps to increase accountability anddecrease the presence of fraudulent providers.
To learn more about the Health CareFraud Prevention and Enforcement Action Team, go to: www.stopmedicarefraud.gov.