Sherman Oaks woman sentenced to six years in prison for health care fraud

A former Sherman Oaks spa owner was sentenced to six years in prison on Friday for running a fraudulent scheme in which millions of dollars in false claims were submitted to insurance companies.

Roshanak “Roxanne” Khadem, 55, was sentenced by U.S. District Judge Stephen V. Wilson, who also ordered her to pay more than $1.2 million in restitution and a $30,000 fine, according to the US Attorney’s office.

She previously pleaded guilty in federal court in Los Angeles to one count of health care fraud and tax evasion. She and four others — including a former fraud investigator at Anthem Blue Cross — were indicted in 2018 in a multi-year conspiracy to commit healthcare fraud against at least eight companies.

Khadem owned and operated R&R Med Spa, located in Valley Village until early 2016, and its successor company, Nu-Me Aesthetic and Anti-Aging Center, which operated in Woodland Hills.

She and others encouraged patients to come to clinics to receive ‘free’ cosmetic procedures, including facials, laser hair removal and Botox injections that weren’t covered by the scheme. insurance.

The conspirators obtained insurance information from patients, using it to bill for unnecessary medical services or services that were never provided.

Khadem and his associates calculated a “credit” that patients could use to receive “free” or discounted cosmetic procedures.

During the scheme, Khadem and other defendants submitted at least $20 million in claims to Anthem and other insurance companies, which paid about $8 million on those claims, according to the indictment. ‘charge.

Gary Jizmejian, 48, of Santa Clarita, former lead investigator for Anthem’s Special Investigations Unit, Anthem’s anti-fraud unit responsible for investigating healthcare fraud against the healthcare company. insurance, pleaded guilty to using his mobile phone to text co-defendants under the commercial bribery scheme. He is serving an 18 month prison sentence.

The other three defendants also pleaded guilty.

The scheme defrauded, among other entities, the International Longshore and Warehouse Union, Pacific Maritime Association Benefit Plan, which is the health benefit plan that covers Southern California stevedores and their dependents, prosecutors said. . Another casualty was the Federal Employees Health Benefits program, which provides health insurance to federal employees.

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