SMP Efforts Pay Off – Hospice Fraudster To pay Over $9 Million to Medicare

hospice fraud, senior medicare patrol, handcuffs, judge, money

The owner of two California-based hospice companies was sentenced earlier this year for his role in a scheme that stole over $9 million from Medicare in false and fraudulent claims for hospice services.

Gayk Akhsharumov, 40, of Glendale, California, the manager and beneficial owner of San Gabriel Hospice and Palliative Care Inc. (San Gabriel) and Broadway Hospice Inc., was sentenced to a short prison term and ordered to pay $9,185,211 in restitution.

This fraud scheme occurred between January 2018 and May 2021 and involved Akhsharumov concealing his ownership and control over his two hospice companies from Medicare, inserting nominee owners, and paying kickbacks to patient recruiters to fraudulently sign beneficiaries up for hospice all while soaking up the money from this profitable scheme. In 2020, our former California Senior Medicare Patrol (SMP) Case Manager, Sandy Morales, reported a hospice fraud case connected to the fraudster to the Office of Inspector General (OIG).

In that case, a service coordinator of a Los Angeles apartment complex contacted SMP after one of her residents was fraudulently enrolled in hospice. Apparently one of the Akhsharumov’s patient recruiters had come to this resident’s door, had her sign papers without her Power of Attorney present, and, unbeknownst to the beneficiary, had her enrolled in hospice. The beneficiary was in good health and not qualified for hospice, as hospice is for those terminally ill with 6 months or less to live.

Yet after her enrollment, she was given unneeded durable medical equipment (DME), oxygen tanks and medications. When the beneficiary’s Power of Attorney, found out about this, she contact the service coordinator who reached out Sandy Morales, former staff at California Senior Medicare Patrol. Sandy guided the PoA to contact the hospice and request she be disenrolled immediately. She then reported this case to OIG, and the Centers for Medicare and Medicaid Services.

Fast forward to 2024, our current SMP Fraud Investigative Analyst, Rose Morales, received a call from the Administration for Community Living (ACL), the government entity funding and overseeing the Senior Medicare Patrol program. They saw that the U.S. Department of Justice’s announcement of resolution of this hospice fraud case was connected to the case our California SMP reported four years earlier. Rose Morales then gathered more information about the OIG’s allocation of dollars and found that in resolving this case, thanks to all the hard work from many entities, including our California Senior Medicare Patrol, $9,043,728 is going back to the Medicare program and this case is now closed. Great job SMP!!

This is excellent news and marks one of many victories in the fight to stop Medicare fraud!

Read more about this case in the Department of Justice’s press release.

Karen Joy Fletcher

Our blogger Karen Joy Fletcher is CHA’s Communications Director. With a Masters in Public Health from UC Berkeley, she is the online “public face” of the organization, provides technical expertise, writing and research on Medicare and other health care issues. She is responsible for digital content creation, management of CHA’s editorial calendar, and managing all aspects of CHA’s social media presence. She loves being a “communicator” and enjoys networking and collaborating with the passionate people and agencies in the health advocacy field. See her current articles.