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Health care firm settles suit alleging Medi-Cal fraud
By Denny Walsh - dwalsh@sacbee.com
Published 12:00 am PDT Wednesday, May 7, 2008
Story appeared in METRO section, Page B2
The owners of a North Natomas day health care facility for adults have agreed to pay the federal government $450,000 to settle a whistle-blower lawsuit alleging they submitted false claims to the state's Medi-Cal program.
Three couples – Miron and Yana Balyasny, Valeriy and Yelena Barash, and Arkady Shturman and Natalia Romachova – and their company, Altamedix Inc., were accused of the fraud in a 2004 civil lawsuit filed on behalf of Deborah Baskin, an occupational therapist who formerly worked at the facility.
Medi-Cal is the state's version of the federal Medicaid program, created by Congress in 1965 to provide payments of medical expenses for low-income patients. In California, the program is funded half with federal funds and half with state funds.
In a settlement agreement signed recently by the parties and their attorneys, the federal and state governments allege the defendants submitted false claims under the Medi-Cal program between February 2001 and February 2005 by:
• Falsifying individualized care plans to qualify patients for funding of unnecessary services.
• Falsifying patients' medical records in support of the plans.
• Billing Medi-Cal for improper and unnecessary therapy.
The governments also allege the Altamedix facility lacked appropriate staffing for the services billed, "and this … likewise renders the subject billings fraudulent" under the federal and state False Claims Acts.
The defendants admit no wrongdoing, but say they signed the pact "to avoid the delay, uncertainty, inconvenience, and expense of protracted litigation."
Under its terms, the defendants are required to pay the federal government $100,000 immediately and the balance over five years, with 5 percent interest compounded quarterly.
Of this, California is to receive $189,000, and Baskin, 16 percent of the total recovered.
About the writer:
- Call The Bee's Denny Walsh, (916) 321-1189.
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