Practicing medicine is usually an honorable profession, but not if the practitioner defrauds the government. A doctor in California, for instance, started padding his bottom line by falsifying claims made to Medicare and Medi-Cal, the state’s Medicaid program.
Dr. Minas Kochumian, a physician with a practice in Northridge, California, submitted false claims to the government insurance programs for at least six years, between September 2013 and December 2019. Kochumian sought reimbursement for injections designed to treat osteoarthritis and osteoporosis, drainage of tailbone cycles, and removal of destructive growths — but the procedures were not actually performed. It’s difficult for fraud like this to be detected. But a former medical assistant for Kochumian and a former information technology consultant to the physician, Elize Oganesyan and Damon Davies, recognized what was happening. They blew the whistle and provided the government with the evidence it needed to bring a civil case and criminal charges against Kochumian.
Fortunately, this story has justice: The doctor settled the civil case with the Department of Justice, and Oganesyan and Davies received an incentive award. Under the settlement, announced June 10, 2022, they will receive a $1.75 million award, not including attorneys’ fees.
As “relators,” the legal term for whistleblowers, Oganesyan and Davies filed their civil case against Kochumian on behalf of the U.S. government in 2017. With help from the evidence they provided, the Justice Department was able to bring criminal charges against Kochumian in 2020. Kochumian was eventually sentenced to 41 months in prison. In his civil settlement with the government, the doctor agreed to pay $9.5 million, including restitution and the payment to the whistleblowers.
As part of the settlement, Kochumian admitted that he intentionally submitted false claims for payment and intended to deceive the United States and California, which administers Medi-Cal. Oganesyan, who worked as a medical assistant to Kochumian, first realized that there could be wrongdoing happening when a patient showed her a Medicare Explanation of Benefits that included a charge for a procedure that hadn’t been performed. The patient showed her a charge for an injection that hadn’t been provided. When Oganesyan saw that information, it stirred her curiosity, and she started looking into more claims and found more charges for services that never happened. Davies, the former I.T. consultant, noticed a similar pattern. Sometimes, the charges on bills were for tests and other services that the clinic didn’t even have the equipment to perform, such as skin allergy tests.
While it’s never easy to accuse your boss of wrongdoing, Oganesyan and Davies took that courageous step. The U.S. government takes fraud against government programs, which are taxpayer-funded, very seriously. That’s why whistleblowers stand to recover as much as 10 percent to 30 percent of any successful damages award or settlement under the False Claims Act. Clearly, it’s not an easy decision to blow the whistle, even if generous compensation is offered as an incentive. Our attorneys are experienced in False Claims Act cases and can help you to protect your rights and maximize any potential reward. We recommend you find an attorney to look out for your interests if you have specific knowledge of fraud and wish to be a whistleblower. Call us today to see if you have a case. 714.907.0697.