Physician Sentenced in Medicare Fraud Scheme: Case Study Lessons for California Healthcare Providers
In June of this year, the United States Department of Justice was proud to announce a four-and-a-half-year prison sentence for a Southern California physician convicted of making false home health certifications and sending fraudulent bills to Medicare. The doctor was also ordered to make nearly $1.5 million in restitution payments to the government. The immense scale of resources the government brings to bear in investigating and prosecuting healthcare fraud and the consequences of a conviction underscore the importance of getting legal advice and representation as early as possible from a skilled attorney.
Learn more about this recent case below. If you find yourself under arrest or your medical practice under investigation in the Los Angeles area, contact The Law Offices of Stanley L. Friedman in Beverly Hills to speak with an experienced California healthcare fraud defense lawyer who specializes in financial fraud and white-collar criminal defense.
Valley Doctor Pleads Guilty to One Count of Health Care Fraud
In June 2025, Dr. Lilit Gagikovna Baltaian, a physician based in Porter Ranch, California, was sentenced to 54 months in federal prison for her involvement in a Medicare fraud scheme. Between 2012 and 2018, Dr. Baltaian pre-signed blank, undated physician certification forms that were later used by home health agencies to bill Medicare for medically unnecessary services. The agencies would then fill in the forms to falsely show that Baltaian had seen patients and certified the need for home health care. Baltaian would receive payments in cash from the agencies for these fraudulent referrals.
Four home health agencies used these false certifications to send fraudulent claims to Medicare over a period of six and a half years, from January 2012 to July 2018. According to the U.S. Department of Justice (DOJ), these fraudulent activities resulted in almost $1.5 million in false claims.
In 2024, Baltaian pled guilty to one count of health care fraud and was ordered to pay restitution in the amount of $1,497,159.64.
On June 12, 2025, Baltaian, who was a fugitive at the time, was sentenced in absentia in a Los Angeles courtroom to spend 54 months in prison.
Case Underscores High Stakes of Healthcare Fraud Investigations and Prosecutions
Cases like this are a stark reminder of the serious consequences healthcare providers face when accused of fraud. Every healthcare professional has the right to defend themselves vigorously in court, and early engagement with an experienced attorney can make a significant difference in the outcome of a case. The government brings enormous resources to bear upon medical providers, as seen here, where both the FBI and the Department of Health and Human Services Office of Inspector General (HHS-OIG) investigated the case, which was then prosecuted by a United States Attorney in the Criminal Division of the Justice Department.
How the DOJ’s Health Care Fraud Unit Operates
The DOJ’s Health Care Fraud Unit is part of the Criminal Division’s Fraud Section and plays a central role in investigating and prosecuting healthcare fraud across the country, as it did in this case. Since its creation in 2007, the unit has charged over 5,400 defendants, involving more than $30 billion in alleged fraudulent claims submitted to federal healthcare programs and private insurers.
The Health Care Fraud Unit leverages data-driven investigations, advanced analytics, and sophisticated financial forensic techniques to identify patterns of potential fraud. These investigations can span multiple years and often involve coordination with a broad network of federal, state, and local agencies. The unit’s goal is not only to prosecute wrongdoing but also to protect public funds and maintain the integrity of federal healthcare programs.
For healthcare providers in California, understanding the scope and power of this unit is critical. The DOJ does not operate in isolation; it brings together resources from multiple agencies to conduct thorough investigations, including:
- Federal Bureau of Investigation (FBI) – Conducts surveillance, gathers evidence, and executes search warrants.
- Department of Health and Human Services Office of Inspector General (HHS-OIG) – Focuses on Medicare and Medicaid fraud, including audits and investigations into billing irregularities.
- Drug Enforcement Administration (DEA) – Monitors potential diversion of controlled substances.
- U.S. Attorneys’ Offices – Prosecute cases in federal court and coordinate strike force efforts.
The Los Angeles Health Care Fraud Strike Force
In addition to national efforts, the DOJ maintains a Healthcare Fraud Strike Force in Los Angeles, dedicated to investigating and prosecuting cases in the region. This Strike Force brings together federal prosecutors, agents from multiple agencies, and financial crime specialists to focus on patterns of fraud specific to Southern California. The Los Angeles Strike Force can deploy substantial manpower and resources to build complex cases, making early legal representation critical for anyone under investigation.
The Complexity of Healthcare Fraud Investigations
Healthcare fraud investigations are highly complex and resource intensive. Federal authorities often spend months or years reviewing financial records, patient charts, billing data, and communications. They may rely on:
- Data analytics to identify anomalous billing patterns
- Patient interviews to verify services were provided
- Financial forensics to trace payments and uncover illicit financial flows
- Undercover operations or cooperating witnesses to substantiate allegations
These investigations are often presented to the public through press releases highlighting the magnitude of the alleged fraud, the number of defendants, and the financial losses involved. While this can paint a dramatic picture, it is important to remember that the government’s version of events is an allegation, and defendants have the right to challenge the evidence and present their side in court.
The Role of Defense Counsel in Healthcare Fraud Cases
Facing federal healthcare fraud charges can be overwhelming. The potential consequences are severe, including prison, fines, restitution, professional license revocation, and long-term reputational harm. That is why working with an experienced defense attorney is essential. A skilled attorney can:
- Evaluate Evidence and Investigate Facts – Review patient records, billing documentation, and internal protocols to identify errors or inconsistencies.
- Challenge Intent or Knowledge – Fraud convictions require proof that the defendant knowingly and willfully engaged in wrongdoing. Many alleged violations stem from misunderstandings, administrative errors, or ambiguous regulations.
- Dispute Government Evidence – Question the methodology of data analysis, the reliability of witness statements, or the chain of custody of financial records.
- Negotiate with Prosecutors – In some cases, plea agreements, deferred prosecution, or other negotiated resolutions may be available.
- Protect Professional Licenses – Address potential civil and regulatory consequences that can arise even if criminal charges are resolved favorably.
Early engagement is especially important because federal investigations are often ongoing before charges are filed. A proactive defense can preserve key evidence, communicate with investigators, and prepare a strategy that mitigates risks.
Why Los Angeles Healthcare Providers Need Local Expertise
California healthcare regulations, combined with federal oversight, create a particularly challenging environment for healthcare providers in LA. The Los Angeles Health Care Fraud Strike Force brings extraordinary resources to bear, making the stakes especially high for providers in Southern California. Providers facing allegations in Los Angeles or nearby areas need defense counsel familiar with local federal prosecutors, the Strike Force’s operational practices, and the nuances of California’s healthcare system.
Stanley L. Friedman: Expertise in Healthcare Fraud Defense
At The Law Offices of Stanley L. Friedman, we specialize in defending healthcare providers against federal and state healthcare fraud allegations in Los Angeles. Stanley L. Friedman is a California State Bar Board-Certified Criminal Law Specialist with decades of experience representing physicians, pharmacists, administrators, and business owners in complex federal investigations.
Our approach is strategic and tailored to each client, focusing on:
- Early assessment of potential exposure
- Rigorous review of government evidence
- Expert consultation on medical and billing practices
- Aggressive advocacy in negotiations or court proceedings
For healthcare providers in Los Angeles and beyond, retaining a defense attorney with deep knowledge of healthcare fraud and the resources of the Los Angeles Strike Force can be the difference between a favorable outcome and devastating consequences.
Contact Healthcare Criminal Defense Attorney Stanley L. Friedman Today
The sentencing of Dr. Baltaian underscores the seriousness of healthcare fraud prosecutions and the significant penalties that can result from even minor deviations from regulatory requirements. The DOJ’s Health Care Fraud Unit, working with multiple agencies and specialized Strike Forces, has the authority and resources to conduct exhaustive investigations into billing practices, patient records, and financial transactions.
Healthcare providers in California must understand the stakes and the importance of early, experienced legal representation. At The Law Offices of Stanley L. Friedman in Beverly Hills, we provide comprehensive defense strategies to protect your rights, your professional license, and your future. Contact our office for more information or immediate assistance.
