By SDCN Staff
A jury in the Central District of California convicted a California doctor in a $45 million scheme to defraud Medicare by submitting claims for Botox injections that were never provided and medically unnecessary, and for obstructing the investigation by manipulating and altering medical records in an attempt to mislead criminal investigators.
The investigation was initiated as a result of a referral from the Health Care Fraud Section’s Data Analytics Team, after its analysis showed that the defendant was paid more by Medicare for Botox injections than any other doctor in the United States.
“Violetta Mailyan falsely diagnosed patients, fraudulently billed for Botox injections while she was actually on lavish vacations, and tried to trick federal agents with fake records,” said Assistant Attorney General Colin McDonald of the Justice Department’s National Fraud Enforcement Division.”
According to court documents and evidence presented at trial, Violetta Mailyan, 45, of Glendale, owned and operated Healthy Way Medical Center, a clinic that purported to provide beauty and cosmetic services. Although Medicare reimburses medical providers for Botox injections when necessary to treat documented cases of chronic migraines, Mailyan billed and received payments for thousands of injections that were never provided or were provided only for cosmetic purposes or for patients whose primary care physicians had not referred them for treatment of chronic migraines. For example, the evidence at trial showed that Mailyan billed for providing Botox injections when she was actually on vacation in Cabo, Mexico; Maui, Hawaii; Las Vegas; Pennsylvania; and New York; billed for purportedly injecting a Medicare beneficiary who was actually incarcerated in federal prison at the time; and billed for thousands of injections, representing over $19 million, purportedly provided on days when her clinic was closed. The evidence also showed that Mailyan backdated some claims to bill for injections purportedly provided before the patients even contacted Mailyan’s clinic to request an appointment, and fabricated patient medical records, including patient consent forms, to make it appear as if patients suffered from chronic migraines and had received treatment for those migraines in her office.
“Let this conviction serve as a warning: anyone who leverages their medical authority to defraud Medicare will be caught and held accountable,” said Acting Deputy Inspector General for Investigations Scott Lampert of the Health and Human Services Office of Inspector General.
In addition to the fraudulent billing, the evidence at trial showed that Mailyan actively sought to cover up her crimes when investigators were closing in. After receiving a grand jury subpoena seeking medical records, Mailyan altered patient records to make it appear as if she had provided Botox injections for chronic migraines when in fact those services had not been provided, and provided the altered documents to federal agents.
The evidence at trial showed that Mailyan used Medicare funds she obtained through the scheme to pay for her lavish vacations in Mexico and Hawaii, and to purchase luxury collectible goods such as a $12,000 17th century crossbow and a $3,000 painting.
