A surgery center owner and former surgeon convicted of a $355 million fraud scheme was denied an appeal of his $100 million restitution order Jan. 16.
According to court documents, the 9th Circuit Court of Appeals in Phoenix affirmed a lower court's forfeiture judgement of almost $100 million in a case where Julian Omidi, MD, who had his license revoked in 2009, and his business, Beverly Hills, Calif.-based Surgery Center Management, were convicted of federal charges arising from his "Get Thin" scheme.
Dr. Omidi defrauded private insurers and the Tricare program by submitting about $355 million in false claims related to the 1-800-GET-THIN Lap-Band surgery business. He set up procedures requiring prospective patients to have at least one sleep study, even when their insurance plans were known not to cover the surgeries in question.
As part of the scheme, commissions were offered to employees to ensure patients participated in the sleep studies designed to find obstructive sleep apnea comorbidities, the Justice Department said. Reports were regularly falsified for preauthorization of the surgical procedures.
Get Thin was able to submit bills for about $15,000 for each sleep study, even when insurers did not authorize the associated surgery, and received around $27 million for these claims, the Justice Department said. Dr. Omidi was found to have fraudulently submitted nearly $120 million in claims related to the scheme.
Dr. Omidi was sentenced to seven years in prison in April 2023.