SHERMAN OAKS—A Sherman Oaks woman pleaded guilty on Tuesday, February 8 to federal criminal charges for conspiring to defraud health insurance companies. Roshanak Khadem, 54, also known as ‘Roxy’, pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of subscribing to a false income tax return.
Her scheme included millions of dollars in fraudulent claims to be submitted to allow patients to receive free cosmetic procedures, including Botox.
Khadem owned and operated many facilities that provided aesthetic services to clients including R&R Med Spa in Valley Village and Anti-Aging Center in Woodland Hills. From January 2012 to April 2016, Khadem performed cosmetic procedures on patients, knowing the procedures were not covered by their insurance. She was also aware that her employees told some patients that if they turned over their health insurance information, the patients would then earn ‘credit’ for future procedures.
The patient’s health insurance information was provided to the insurance biller for the clinics, knowing that the insurance information would be used to submit fraudulent claims. After receiving the money from the health insurance companies from the fraudulent claims, Khadem and others would take a portion of the money and award it to patients as ‘credit’ and keep the rest of the money.
The United States Justice Department reported that funds from the health care fraud conspiracy were deposited into bank accounts that were held in the names of doctors who were affiliated with the clinics and signed off on and caused to be submitted the false and fraudulent claims under their names.
Khadem took possession of the proceeds from the doctors’ accounts in two ways. First, as the signatory authority on the bank accounts, she was able to obtain the funds by writing checks on the accounts. Second, she would withdraw funds from the bank accounts using pre-signed checks that she obtained from the doctors.
From January 2012 thru April 2016, Khadem and her employees submitted false claims where insurance companies paid out at least $1,361,200. Prosecutors suggest that the amount paid for false claims could be as much as $7,991,406.
The defendant failed to report the income on her income tax returns for 2013, 2014, and 2015, which caused a total tax loss of $453,451.
United States District Judge Stephen V. Wilson scheduled a sentencing hearing for June 27, 2022, where Khadem will be facing a statutory maximum sentence of 13 years in federal prison.