California Physician Sentenced for $1.5M Medicare Home Health Fraud Scheme

Lilit Gagikovna Baltaian, a California-licensed physician and Medicare provider, was sentenced in absentia to over four years in federal prison for orchestrating a health care fraud scheme involving false home health certifications. Between January 2012 and July 2018, she falsely certified patients to receive home health care, enabling four Los Angeles area home health agencies to submit fraudulent Medicare claims totaling nearly $1.5 million.

Baltaian pre-signed blank, undated certification forms, which were then falsified by agencies to fabricate clinical validation of home care needs. She received illicit cash payments for referrals and billed Medicare for signing these fraudulent certifications. The court also ordered Baltaian to pay restitution of nearly $1.5 million for the Medicare losses.

This case highlights ongoing risks in Medicare home health claim certification processes and underscores the importance of compliance controls to prevent fraudulent billing and reimbursements within the healthcare payer and provider system.