A former dermatologist was sentenced to seven years in prison for fraudulently submitting nearly $120 million in claims related to the 1-800-GET-THIN Lap-Band surgery business.
Julian Omidi, 54, of West Hollywood, Calif., submitted fraudulent claims to private health insurance companies and Tricare, according to an April 18 Justice Department news release.
Mr. Omidi controlled, in part, the Get Thin network of entities that focused on the promotion and performance of Lap-Band weight-loss surgeries, according to the release. Mr. Omidi established procedures requiring prospective patients — even those with insurance plans he knew would not cover Lap-Band surgeries — to have at least one sleep study. Employees were incentivized with commissions to ensure the studies took place.
Mr. Omidi used the studies to find a reason to convince patients' insurance companies to pre-approve the Lap-Band procedure, according to the release.
After the patients underwent the study, Get Thin employees often falsified the results at Mr. Omidi's direction. He then used the falsified study results in support of Get Thin's pre-authorized requests for Lap-Band surgery, according to the release.
Insurance companies authorized payment for some of the proposed surgeries relying on the falsified studies and other false information, such as patients' weights, according to the release. Even if insurance companies did not authorize the surgery, Get Thin was able to submit $15,000 bills for each sleep study.
Mr. Omidi was convicted of the scheme in December 2021, according to the release. His medical license was revoked in 2009 after authorities found had engaged in dishonesty and unprofessional conduct related to his application for his California medical license.