A physician assistant who worked at fraudulent medical clinics where he used the stolen identities of doctors to write prescriptions for medically unnecessary durable medical equipment (DME) and diagnostic tests has been convicted of conspiracy, health care fraud, and aggravated identity theft charges in connection with a $18.9 million Medicare fraud scheme.
After a two-week trial in federal court in Los Angeles, a jury on Friday
afternoon found David James Garrison, 50, of Leimert Park, guilty of one count
of conspiracy to commit health care
fraud, six counts of health care fraud, and one count of aggravated identity
The evidence at trial showed that Garrison worked at fraudulent medical
clinics that operated as prescriptions mills and trafficked in fraudulent
prescriptions and orders for medically unnecessary DME, such as power
wheelchairs, and diagnostic tests. The fraudulent prescriptions and orders were
used by fraudulent DME supply companies
and medical testing facilities to defraud Medicare. Garrison wrote the
prescriptions and ordered the tests on behalf of some doctors he never met and
who did not authorize him to write prescriptions and order tests on their
The trial evidence showed that between March 2007 and September 2008,
Garrison’s co-conspirator, Edward Aslanyan, and others owned and operated
several Los Angeles medical clinics established for the sole purpose of
defrauding Medicare. Aslanyan and others hired street-level recruiters to find
Medicare beneficiaries willing to provide the recruiters with their Medicare
billing information in exchange for high-end power wheelchairs and other DME,
which the patient recruiters told the beneficiaries they would receive for free.
Often, the Medicare beneficiaries did not have a legitimate medical need for the
power wheelchairs and equipment. The patient recruiters provided the
beneficiaries’ Medicare billing information to Aslanyan and others, or they
brought the beneficiaries to the fraudulent medical clinics. In exchange for
recruiting the Medicare beneficiaries, Aslanyan and others paid the recruiters
Many of the beneficiaries whose Medicare billing information was used at the
medical clinics lived hundreds of miles from the clinics, including some
beneficiaries who lived more than 300 miles from the clinics. One witness
testified that the clinics used beneficiaries who lived such long distances from
the clinics because the billing numbers of Medicare beneficiaries who lived in
and around Los Angeles had been used in other Medicare fraud schemes and,
therefore, could no longer be used to bill Medicare.
The evidence presented at trial showed that Garrison wrote prescriptions for
power wheelchairs that the beneficiaries did not need and did not use. In some
cases, Garrison wrote power wheelchair prescriptions for beneficiaries he never
examined and who never visited the clinics. In one instance, according to the
evidence presented at trial, Garrison prescribed a power wheelchair to a
beneficiary who did not have the mental capacity to operate the wheelchair.
Once Garrison wrote the power wheelchair prescriptions, Aslanyan and others
sold the prescriptions for as much as $1,500 to the owners and operators of
approximately 50 fraudulent DME supply companies. The fraudulent prescriptions were
used to submit fraudulent power wheelchair claims to Medicare. The DME supply
companies purchased the power
wheelchairs wholesale for approximately $900 per wheelchair but submitted bills
to Medicare at a rate of approximately $5,000 per wheelchair.
The trial evidence also showed that Garrison ordered medically unnecessary
diagnostic tests for many Medicare beneficiaries, including tests for sleep
studies, ultrasounds, and nerve conduction. These tests were then billed to
Medicare by fraudulent diagnostic testing companies that paid Aslanyan kickbacks to
operate from the medical clinics.
Throughout the trial, evidence was introduced that showed that Garrison had
admitted to writing prescriptions for power wheelchairs and ordered diagnostic
tests on behalf of approximately six different doctors and that he did not have
a Delegation of Services Agreement with at least two of these doctors, as
required by law.
As a result of this fraud scheme, Garrison, Aslanyan, and their
co-conspirators submitted and caused the submission of more than $18 million in
false and fraudulent claims to Medicare, which paid approximately $10.7 million
on those claims.
Garrison is scheduled to be sentenced by United States District Judge
Consuelo B. Marshall on September 17. At that time, Garrison faces a maximum
statutory penalty of 72 years in federal prison and a $2 million fine. The
aggravated identity theft conviction carries a mandatory two year prison
Currently, Garrison is facing federal drug charges as a result of his alleged
involvement with another medical clinic where medically unnecessary
prescriptions for Oxycontin were distributed (see: http://www.justice.gov/usao/cac/Pressroom/2011/147.html).
Garrison is scheduled to go on trial in the drug case on November 6. He is
presumed innocent of the charges against him in this case.
The conviction of Garrison was announced by Assistant Attorney General Lanny
A. Breuer of the Justice Department’s Criminal Division; United States Attorney
André Birotte, Jr.; Tony Sidley, Assistant Chief of the California Department of
Justice, Bureau of Medi-Cal Fraud and Elder Abuse; Glenn R. Ferry, Special Agent
in Charge for the Los Angeles Region of the HHS Office of Inspector General
(HHS-OIG); and Steven Martinez, Assistant Director in Charge of the FBI’s Los Angeles Field Office.
The case is being prosecuted by Assistant United States Attorney David Kirman
and DOJ Trial Attorney Jonathan T. Baum.
The case was brought as part of the Medicare Fraud Strike Force, supervised
by the Criminal Division’s Fraud Section and the United States Attorney’s Office
for the Central District of California. The Medicare Fraud Strike Force
operations are part of the Health Care Fraud Prevention and Enforcement Action
Team (HEAT), a joint initiative announced in May 2009 between the Department of
Justice and HHS to focus their efforts to prevent and deter fraud and enforce
current anti-fraud laws around the country.
Since their inception in March 2007, strike force operations in nine
districts have charged 1,330 defendants who collectively have falsely billed the
Medicare program for more than $4 billion. In addition, the HHS Centers for
Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are
taking steps to increase accountability and decrease the presence of fraudulent
providers. To learn more about HEAT, go to www.stopmedicarefraud.gov.
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