- Fake Certifications: From 2012 to 2018, Dr. Baltaian signed off on home health care for patients, even though they didn’t need it.
- Pre-Signed Blanks: In some cases, Dr. Baltaian even pre-signed blank forms, knowing home health agencies would fill them in later to make it seem like she examined patients (which she didn’t).
- Kickbacks and Fraudulent Claims: Dr. Baltaian reportedly received cash for these phony referrals and even submitted her own bills to Medicare for signing the fabricated certifications.
The result? Four home health agencies used Dr. Baltaian’s bogus certifications to submit a staggering $1.45 million in fraudulent claims to Medicare.
The Impact: How Does This Affect You?
Medicare fraud schemes like this one can have a ripple effect, ultimately impacting you – the taxpayer who funds these programs. Here’s why we should care:
- Higher Costs: When Medicare loses money to fraud, it can lead to program cuts or increased premiums for beneficiaries down the line.
- Erosion of Trust: These schemes undermine public trust in the healthcare system, making it harder to ensure everyone has access to the care they need.
- Focus Shifts: Resources that could be used to improve healthcare services and access might be diverted to fighting fraud.
Dr. Baltaian faces a maximum sentence of 10 years in prison when she’s sentenced in April 2025. The judge will consider federal sentencing guidelines and other factors when determining her punishment.
Federal agencies like the FBI and the Department of Health and Human Services Office of Inspector General (HHS-OIG) are actively investigating and prosecuting these crimes. You can find more information about the Department of Justice’s efforts to combat healthcare fraud here.
Empowering Yourself: How to Stay Informed
While these schemes can seem complex, there are steps you can take to protect yourself and Medicare:
