Crime - Sacto 911

Doctor sentenced for role in Medicare fraud scheme involving Carmichael clinic

A Southern California physician has been sentenced to prison for his role in a Medicare fraud scheme that involved clinics in Carmichael and Sacramento.

U.S. District Judge Morrison C. England Jr. today sentenced Dr. Emilio Louis Cruz III, 61, of Carson to three years and two months in prison and ordered him to pay $601,581 in restitution, according to a federal Department of Justice news release.

According to court documents, Cruz earned an undergraduate degree from Johns Hopkins University and his medical degree from Yale University. He held medical licenses in three states and was board certified in neurology. According to his plea agreement and testimony during the trial of Cruz’s co-defendants, doctors Ramanathan Prakash, Alexander Popov and Lana LeChabrier, along with a man named Vardges Egiazarian owned and controlled three health care clinics, in Sacramento, Carmichael and Richmond, from February 2006 through August 2008. During this time, Cruz ran the practice at the Carmichael clinic at 3609 Mission Ave.

Authorities said Cruz established a Medicare provider number for the clinic and a bank account into which Medicare funds were deposited. Hundreds of claims were submitted to Medicare seeking reimbursement for services allegedly performed at the Carmichael clinic under Cruz’s care.

Cruz however, never treated patients at the clinic. During the majority of time the Carmichael clinic operated, he was living and practicing in North Dakota. Authorities said a similar pattern was followed at the other two clinics operated by Egiazarian, and none of they physicians submitting bills to Medicare ever treated patients at the clinics.

In all, the three clinics submitted more than $5 million worth of fraudulent claims to Medicare, $1.7 million of which was paid. Of the claims submitted for services purportedly provided by Cruz at the Carmichael clinic, Medicare paid $601,581, authorities said.

The only defendants to go to trial in the case – doctors Prakash, Popov and LeChabrier – were found guilty by a jury in July 2008 of conspiracy to commit healthcare fraud and various counts of healthcare fraud.

Egiazarian and six other people entered guilty pleas for their various roles in the scheme.

The case resulted from an investigation by the Office of the Inspector General for the Department of Health and Human Services and the Federal Bureau of Investigation.