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A former California physician, 54 year old Julian Omidi who lives in West Hollywood, was sentenced Monday to seven years behind bars for using fabricated sleep studies to persuade insurance companies to pay out tens of millions of dollars for Lap-Band surgery. Fines and restitution are to be determined at a hearing in June.

The U.S. Attorney’s office reported that the former doctor and his company were found guilty in December 2021 by a federal jury of scheming to defraud private insurance companies and the Tricare health care program for military service members by fraudulently submitting an estimated $355 million in claims related to the 1-800-GET-THIN Lap-Band surgery business.

Julian Omidi, 53, of West Hollywood, and an Omidi-controlled Beverly Hills-based company, Surgery Center Management LLC (SCM), were found guilty of 28 counts of wire fraud and three counts of mail fraud. Omidi also was found guilty of two counts of making false statements relating to health care matters, one count of aggravated identity theft and two counts of money laundering. Omidi and SCM were found guilty of one count of conspiracy to commit money laundering.

According to evidence presented at his three-month trial, Omidi, a physician whose license was revoked in 2009, controlled, in part, the GET THIN network of entities, including SCM, that focused on the promotion and performance of Lap-Band weight-loss surgeries. Omidi established procedures requiring prospective Lap-Band patients – even those with insurance plans he knew would never cover Lap-Band surgery – to have at least one sleep study, and employees were incentivized with commissions to make sure the studies occurred.

Omidi used the sleep studies to find a reason – the “co-morbidity” of obstructive sleep apnea – that GET THIN would use to convince the patient’s insurance company to pre-approve the Lap-Band procedure.

After patients underwent sleep studies – irrespective of whether any doctor had ever determined the study was medically necessary – GET THIN employees, acting at Omidi’s direction, often falsified the results. Omidi then used the falsified sleep study results in support of GET THIN’s pre-authorization requests for Lap-Band surgery.

Relying on the false sleep studies – as well as other false information, including patients’ weights – insurance companies authorized payment for some of the proposed Lap-Band surgeries. GET THIN received an estimated $41 million for the Lap-Band procedures.

Even if the insurance company did not authorize the surgery, GET THIN still was able to submit bills for approximately $15,000 for each sleep study, receiving an estimated $27 million in payments for these claims. The insurance payments were deposited into bank accounts associated with the GET THIN entities.

Prosecutors estimate Omidi’s total fraudulent billings at approximately $355 million. The victim health care benefit programs include Tricare, Anthem Blue Cross, UnitedHealthcare, Aetna, Health Net, Operating Engineers Health and Welfare Trust Fund, and others. In 2014, the government seized more than $110 million in funds and securities from accounts held by individuals and entities involved in the criminal scheme, including Omidi.

According to Courthouse News, prosecutors had asked for a sentence of 22 years, even though under federal sentencing guidelines, Omidi could be sent to prison for life given the high amount of “intended” financial losses to his victims, including TRICARE, the U.S. military’s health care program.

The judge said she believed that the crimes Omidi had committed were serious but that the federal guidelines for fraud convictions were disproportionate.

“You could have earned a fine living without resorting to fraud,” she told Omidi, referring to his family background and education. “You should have known better.”

Omidi, before the judge imposed the sentence, told her that he was sorry and ashamed to be standing before the court.  “I live in constant remorse,” he said. “I worked hard all my life and tried to do the right thing. I didn’t want to harm anyone.”

Omidi’s lawyers had asked for a sentence of as low as 24 months in prison, arguing that the actual losses to the insurers were far less than the intended losses the government claimed and that two years incarceration would be sufficient punishment for a middle-aged man who has never been to prison before.

Omidi’s mother, Cindy, was sentenced to probation in 2015 after she was convicted of violating laws designed to prevent money laundering.