Date: 07-26-2015

Case Style: United States of America v. Haroutyoun Margossian

Case Number: 1:15-cr-00342-KAM

Judge: KAM

Court: United States District Court for the Eastern District of New York (King County=)

Plaintiff's Attorney: Patricia E. Notopoulos and Jill D. Brenner

Defendant's Attorney: Florian Miedel and Aaron J. Mysliwiec

Description: Brooklyn, NY - Board Certified Obstetrician And Gynecologist Agrees To Civil Fraud Settlement In Conjunction With Deferred Prosecution In Medicare And Medicaid Fraud Investigation

The United States and New York State have entered into a civil settlement agreement with Haroutyoun Margossian, a Board Certified Obstetrician and Gynecologist (OB/GYN). Margossian maintains an OB/GYN subspecialty in urogynecology and is the sole practitioner at NY Urogynecology & Reconstructive Pelvic Surgery, P.C. with a main office located in Brooklyn. The agreement resolves an investigation under the federal False Claims Act and the New York False Claims Act involving allegations that, in contravention of Medicare and Medicaid regulations, Margossian utilized an unlicensed and often unsupervised staff to treat women suffering from urinary incontinence. Under the terms of the civil settlement agreement, Margossian will pay a total of $8,047,291.06. Contemporaneously with the execution of the civil settlement agreement, the government filed a criminal charge against Margossian for making false statements to Medicare and entered into a deferred prosecution agreement with him.

The civil settlement agreement, criminal charge, and deferred prosecution agreement were announced by Kelly T. Currie, Acting United States Attorney for the Eastern District of New York, Scott J. Lampert, Special Agent-in-Charge, Health and Human Services, Office of Inspector General (HHS-OIG), New York Region, and Diego G. Rodriguez, Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI).

The government’s investigation revealed that between approximately January 1, 2007 and December 31, 2013, the primary focus of Margossian’s practice was the treatment of woman suffering from incontinence. Patients received urodynamics testing and underwent pelvic floor rehabilitation by an unlicensed staff without proper physician supervision. Margossian was often absent from the office while conducting surgery at area hospitals and, at times, on vacation out of the country. Medicare and Medicaid rules required that these procedures be performed by a licensed physician or licensed physical therapist, or a properly trained medical provider under the physician’s direct supervision. Furthermore, Margossian used improper billing codes to bill Medicare for the pelvic floor rehabilitation, which substantially increased Margossian’s Medicare reimbursement.

The deferred prosecution agreement requires Margossian to install an independent billing monitor of his practice. As part of the deferred prosecution agreement, Margossian is obligated to comply with the terms of the civil settlement agreement under which he is paying the government over $8 million. If Margossian abides by all of the terms of the deferred prosecution agreement for two years, the government will then seek dismissal of the charge.

“Those who jeopardize the health and safety of their patients, while at the same time knowingly submitting false claims to Medicare, Medicaid, and other government health care programs, will be pursued to the full extent of the law,” stated United States Attorney Currie. Mr. Currie thanked HHS-OIG, the FBI, and the New York Attorney General’s Medicaid Fraud Control Unit for their assistance in the investigation.

“It is distressing to learn that a physician would be so driven by profit that he allowed his unlicensed employees to conduct testing and provide treatment to patients when he was not present, and at times, when he was out of the country. HHS-OIG and our law enforcement partners will not tolerate this behavior, and we will remain vigilant in our efforts to protect patients’ welfare,” said HHS-OIG Special Agent-in-Charge Lampert.

“Health care fraud is ultimately a financial crime, which can lead to significant loss to both victims and government programs. Through successful engagement with our partners, the FBI is protecting potential victims and ensuring Medicare billing is utilized within the boundaries of the law,” said FBI Assistant Director-in-Charge Rodriguez.

The United States’ civil case was handled by Assistant U.S. Attorney Kenneth M. Abell, with assistance from Kaitlyn L. Dunn of the Office of Counsel to HHS-OIG.

Outcome: Haroutyoun Margossian to Pay Over $8 Million Under the False Claims Act

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