Medicare Scam: Woman Arrested After Swindling $6 Million

Medicare Scam: Woman Arrested After Swindling $6 Million

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A woman has been arrested after creating fake billings for home health care that defrauded Medicare for $6 million.

Lilit Gagikovna Baltaian, 58, of Porter Ranch, California was arrested Thursday for her role in a scam that saw her connecting patients with home healthcare companies. Police explained that the companies would bill Medicare for services that weren’t actually provided, and they would then send Baltaian kickbacks for her role in the scheme.

Baltaian’s alleged role in the scam was that of “fixer,” as she would connect the patients with the health providers. While billing a government healthcare plan might seem like a victimless crime, it’s actually a huge drain on the program. While there are people in need of real medical help, unscrupulous companies are bleeding the program with fraud schemes.

How the Scam Worked

Registered nurses and doctors are able to authorize home treatments for people who are homebound. For various reasons, many people are unable to get treatment from hospitals, whether it’s due to a disability, age, or illness. In these cases, the health provider simply bills Medicare directly for the services rendered.

This system was apparently uniquely vulnerable to fraud. Without hospital administrators overseeing the billing, it was difficult for Medicare to detect that these were false claims. Normally, these claims are for things like injections, teaching caregivers at the home how to apply certain medications, or changing wound dressings.

Baltaian Faces Serious Charges

Baltaian faces serious charges for her alleged role in the scam. She is looking at four charges of healthcare fraud, which would carry a maximum sentence of 40 years behind bars if she’s found guilty. At the time of this writing, it’s not clear whether she’s secured a lawyer yet. Likewise, authorities didn’t release any official numbers on the number of false claims filed by Baltaian’s alleged co-conspirators.

The charges she faces are indicative of the seriousness of the crime she’s accused of. Defrauding Medicare is tantamount to stealing from the elderly. Medicare was created specifically to help older Americans cover their medications, but people who choose to defraud the program only make things harder for everyone else.

The worst knock-on effect of this scam, sadly, will be the ever-tightening rules about Medicare claims. Now, it will likely be even harder for people in real need to get the money to pay for their home health care. Scammers often act without regard for the damage their shortsighted greed will cause, sadly.