Healthcare example. Photo via Pixabay.

A Sherman Oaks woman pleaded guilty Tuesday to federal charges for her leadership role in a fraud scheme in which more than $20 million in bogus claims were submitted to insurance companies.

Roshanak “Roxanne” Khadem, 54, and four others — including a former fraud investigator at Anthem Blue Cross — were charged in a multiyear conspiracy to commit health care fraud against at least eight companies, according to the U.S. Attorney’s Office.

She pleaded guilty in Los Angeles federal court to one count each of health care fraud and tax evasion. U.S. District Judge Stephen V. Wilson scheduled a June 27 sentencing hearing, at which time Khadem will face up to 13 years in federal prison.

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 induced patients to visit the clinics to receive “free” cosmetic procedures, including facials, laser hair removal and Botox injections which were not covered by insurance.

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

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

During the course of 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 filed in 2018.

The remaining four defendants each pleaded guilty.

In November, Gary Jizmejian, 48, of Santa Clarita, a former fraud investigator at Anthem, was sentenced to a year and a half behind bars for his role.

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 longshore workers in Southern California and their dependents, prosecutors said. Another alleged victim was the Federal Employees Health Benefits Program, which provides health insurance for federal employees.

Leave a comment

Your email address will not be published.