Ophthalmologist pleads guilty to theft of state Medicare and Medicaid programs | State Attorney General
April 14, 2012 · 9:39 PM
An ophthalmologist today plead guilty to stealing more than $51,000 from state and federal health care programs. In July, state prosecutors charged Dr. Behrouz Pirouzkar with three counts of First Degree Attempted Identity Theft and two counts of Medicaid False Statement.
“This was a particularly brazen case of fraud and we’re happy to see justice done today,” said Assistant Attorney General Carrie Bashaw of the Washington State Attorney General’s Medicaid Fraud Control Unit (MFCU).
From October 2002 to May 2009, state and federal investigators say Pirouzkar fraudulently billed Medicaid and Medicare, receiving payments for services he didn’t actually provide. Among the charges, investigators say the doctor used Medicaid patients’ Personal Identification Code (PIC) numbers to submit bills to the federal and state-funded programs. At one point, investigators say the doctor claimed a patient had 138 appointments with him between 2002 and 2008. The patient said otherwise. Some patients say they don’t even know Pirouzkar. Others are familiar with him but say they did not receive the treatments for which he bill Medicaid.
In October, 2008 the Department of Social and Health Services (DSHS) made the Attorney General’s Medicaid Fraud Control Unit (MFCU) aware of the suspicious bills and payments. MFCU Senior Investigator Bill Lemp, MFCU Auditor Sally Odiorne, and Special Agent Michelle Bailey of the Office of the Inspector General (OIG), US Department of Health & Human Services, conducted the investigation.
“Dr. Pirouzkar betrayed his colleagues and defrauded taxpayers by billing for services he never performed”, said Christian Schrank, an Assistant Special Agent in Charge of the Office of Inspector General, U.S. Department of Health and Human Services. “We will continue our collaboration with the Washington MFCU to investigate and prosecute those who steal from the Medicaid and Medicare programs.”
Pirouzkar was sentenced to 240 hours community service to be completed within six months. He was also ordered to pay $52,109 in restitution, fees, and costs, of which he today paid more than half.
MFCU, within the Attorney General’s Corrections Division, is responsible for investigating and prosecuting provider fraud in the Medicaid system. OIG fights fraud in federal government programs.