Arizona Fraud Unit Stops Medical ID Theft Ring

October 29, 2010

The Arizona Department of Insurance has announced that Gevorg Melkonyan and Elina Arutyunova have been criminally charged for their role in allegedly stealing the medical identity of several Arizona patients and then falsely billing insurance companies for medical services never provided. Their conduct created an inaccurate, and potentially harmful, medical history for the patients involved and an administrative headache for the doctors whose names were falsely used.

The suspects used the insurance records of 128 patients to submit phony claims totaling more than $600,000 to 10 insurance companies, the DOI said. They also used the names and/or tax identification numbers of 12 reputable Arizona physicians, including Dr. Scott Bernstein, who reported the fraud to the Arizona Department of Insurance Fraud Unit.

Dr. Bernstein became suspicious when patients he had never seen contacted him indicating their insurance statements showed he had billed their insurance for treatment.

Gevorg and Elina were indicted on charges of conspiracy, illegally conducting an enterprise, assisting a criminal syndicate, fraudulent schemes and artifices, money laundering, three counts of theft, and aggravated taking the identity of another person or entity.

This case was investigated by the Arizona Department of Insurance Fraud Unit, with help from the Phoenix Police Department, Chandler Police Department, Arizona Attorney General’s Office, U.S. Department of Human and Health Services, and the National Insurance Crime Bureau. The U.S. Postal Service was integral to the success of the Insurance Department’s investigation, the DOI said.

Medical identity theft, a growing problem, occurs when someone uses personal medical benefit information without the person’s knowledge to obtain or receive payment for medical treatment, services, or goods, the DOI said. This scam is on the rise and has serious ramifications for patients and the medical community. It is particularly dangerous because it puts patients at risk if their medical record contains harmful errors that could impact their future medical treatment or their ability to get insurance.

This type of fraud happens in all types of health plans, including private health insurance, as well as government benefit plans such as Medicare and Medicaid, the DOI said.

Source: DOI

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