Sherman Oaks woman to plead guilty in health care fraud case

A Sherman Oaks woman who owned two medical clinics is expected to plead guilty Thursday to federal charges for her alleged leadership role in a scheme in which more than $20 million in bogus claims were submitted to insurance companies.

Roshanak “Roxanne” Khadem, 54, was among five defendants — including a former fraud investigator at Anthem Blue Cross — charged in the multi-year conspiracy to commit health care fraud against at least eight companies, according to the U.S. Attorney’s Office.

She has agreed to plead guilty in Los Angeles federal court to one count each of health care fraud and tax evasion.

Khadem owned and operated R&R Med Spa, located in Valley Village until early 2016, and its successor company, Nu-Me Aesthetic and Anti-Aging Center, which operated in Woodland Hills.

Federal prosecutors allege that Khadem and others induced patients to visit the clinics to receive “free” cosmetic procedures, including facials, laser hair removal and Botox injections which were not covered by insurance.

The suspected conspirators obtained the insurance information from the patients and fraudulently billed insurance companies for the unnecessary medical services or for services that were never provided, the indictment alleges.

Khadem and her associates calculated a “credit” that patients could use to receive the “free” or discounted cosmetic procedures, prosecutors contend.

During the course of the scheme, Khadem and co-defendants submitted at least $20 million in claims to Anthem and other insurance companies, which paid about $8 million on those claims, according to the indictment filed in 2018.

In November, Gary Jizmejian, 48, of Santa Clarita, a former senior investigator at Anthem’s anti-fraud unit responsible for investigating fraud committed against the company, was sentenced to a year and a half behind bars for his role.

The scheme defrauded, among other entities, the International Longshore and Warehouse Union, Pacific Maritime Association Benefit Plan, which is the health benefit plan that covers longshore workers in Southern California and their dependents, according to prosecutors. Another alleged victim was the Federal Employees Health Benefits Program, which provides health insurance for federal employees.