Anyone doubting that health care providers enable union benefit fraud probably hasn’t looked at Southern California lately. Mahyar David Yadidi, a Los Angeles-area chiropractor, was sentenced yesterday in federal court to 46 months in prison for submitting about $4.8 million in fraudulent reimbursements to an International Longshore and Warehouse Union health plan, and ordered to pay nearly $2 million in restitution. Yadidi had pleaded guilty last November after being charged in September. Two clinic employees, Ivan Semerdjiev and Julian Williams, had received prison sentences, respectively, of one year and six months. The actions follow a probe by the U.S. Labor Department’s Office of Labor-Management Standards, Office of Inspector General, and Employee Benefits Security Administration, part of a larger investigation into Medicare and Medicaid fraud.
Mahyar David Hadidi, now 38, a resident of West Los Angeles, operated a chiropractic clinic in nearby San Pedro called Synergy Healthcare and Wellness Center. Unfortunately, he saw the center as an opportunity to fleece a health plan sponsored by the International Longshore and Warehouse Union – Pacific Maritime Association (ILWU-PMA). According to prosecutors, during July 2016-October 2018, Yadidi, aided by chiropractor Ivan Semerdjiev and (unlicensed) personal trainer Julian Williams, recruited union plan enrollees to visit the clinic. They often enticed them with a $50 cash kickback for each visit and another $50 each time they allowed him to bill the plan in absence of a visit. Yadidi then billed, or caused his employees to bill, the plan for nonexistent or medically unnecessary services. To conceal the fraud, Yadidi then instructed employees to falsify medical records by inserting inaccurate information on patient sign-in sheets listing the dates of the supposed services. He also told Semerdijev to place patient files in the names of relatives, as the plan covered visits by relatives.
In August 2017, about a year into the billing scheme, suspicious ILWU-PMA health plan administrators terminated Yadidi’s service provider contract. Yadidi responded with more fraud. He changed the name of his facility to San Pedro Philips Chiropractic and continued to operate it in the name of another person, submitting false claims in that person’s name. Eventually, the U.S. Department of Labor initiated an investigation, concluding that Yadidi had been running a scam. The DOL then referred the case to the Justice Department. Yadidi pleaded guilty to conspiracy in November 2019; Semerdjiev and Williams pleaded guilty separately. Given that the fake claims totaled nearly $5 million, Yadidi’s 46-month prison sentence is amply justified. He also was ordered by U.S. District Judge R. Gary Klausner to pay $1,976,832 in restitution. The International Longshore and Warehouse Union should use this case as an opportunity to insulate itself from further health plan abuse.