A former Van Nuys doctor, medical executive and the clinic and laboratory where they worked will pay $15 million to settle allegations that they submitted false Medicare and Medi-Cal claims, paid illegal kickbacks and self-referred patients, according to the Department of Justice.
The DOJ announced on Thursday, Dec. 26 that the former doctor, Mohammad Rasekhi of Van Nuys, and an executive that worked for the lab and clinics, Sheila Busheri, and the lab and clinics agreed to pay to settle the claims.
“There is an expectation that providers who receive Medicare and Medicaid program funds obey the law and operate with integrity,” said Acting Special Agent in Charge Eric Larson of the U.S. Department of Health & Human Services Office of the Inspector General.
The allegations state that the defendants “knowingly submitted or caused the submission of false claims to Medicare and Medi-Cal.”
They allegedly did this by paying kickbacks to marketers to refer patients to their clinics, paying kickbacks to third-party clinics to refer Medicare and Medi-Cal patients to their laboratories and referring patients from their clinics to their laboratory when self-referral, or referral to an entity that a physician or their family member has a financial relationship with, is not allowed.
The kickbacks to third-party clinics for referring patients to their labs were allegedly “above-market rent payments, complimentary and discounted services to clinic staff, and write-offs of balances owed by patients and clinic staff.”
Rasekhi founded Southern California Medical Center (SCMC) and served as its chief medical officer and co-owns Universal Diagnostic Laboratories. Busheri is the chief executive officer of SCMC and co-owns and is the chief executive officer of Universal Diagnostic Laboratories (UDL). SCMC has six clinics throughout Southern California.
Rasekhi, Busheri, UDL and SCMC are accused of violating the Anti-Kickback Statue and the Physician Self-Referral Law. Rasekhi surrendered his medical license in Dec. 2024.
Former employees and managers of the labs and clinics filed a claim under the False Claims Act, under the whistleblower provisions. They filed on behalf of the United States and will receive $5 million in the settlement. The DOJ calls the False Claims Act “one of the most powerful tools” in the fight against healthcare fraud.
The state of California, which paid some of the claims involved, will receive $7 million.