A Los Angeles businessman has been indicted in Pittsburgh in a complex health care fraud scheme using bariatric patients to rip off health insurance companies, including Highmark.
Seyed Hamed Razavi Rahmani, 39, was charged Tuesday with conspiracy to commit health care fraud following an investigation by the FBI.
Rahmani owned Ramni Enterprises and also operated Insure Nutrition, a purported pharmacy that provided bariatric patients with free nutritional shakes as an inducement to obtain patients’ medical insurance information.
The grand jury said that information was then used to market expensive medications those patients didn’t need. Insure gained access to buyers’ personal data and insurance coverage so the company could bill insurance, including AHN for Pittsburgh-area beneficiaries, for those products.
As part of the scheme, Insure did not collect co-payments on the expensive medicines and “fabricated procedures to mislead auditors” regarding those co-payments, prosecutors said.
The indictment includes examples of two Highmark beneficiaries — one in Erie and one in Pittsburgh — whose health care data was used so Insure could bill Highmark.
The U.S. attorney’s office said several other defendants in the scheme have already pleaded guilty and have forfeited more than $54 million in fraudulent proceeds, which has been paid to the victimized insurance carriers.
Rahmani is set to be arraigned in federal court July 18.