Manager of Altamedix Facility for the Elderly is Sentenced
for Submitting False Medi-Cal Claims
Defendant Claimed "Patients" Were Sick to Obtain Medi-Cal Funds

SACRAMENTO, Calif.—United States Attorney McGregor W. Scott announced today that MIRON BALYASNY, 57, of San Francisco, Calif., was sentenced today by United States Magistrate Judge Edmund F. Brennan to a term of five years probation, including six months of home confinement, during which he will be on electronic monitoring. He will also be required to pay a fine of $4,000. BALYASNY pleaded guilty in March 2008 to making false demands against the United States.

This case is the product of an extensive joint investigation by the FBI and the Department of Health and Human Services (HHS) Office of Inspector General.

According to Assistant United States Attorney Anne Pings, who prosecuted the criminal case, BALYASNY acknowledged that between January 1, 2001 and December 31, 2004, he was the Administrator and Manager of Altamedix, Incorporated, which operates an adult day health care (ADHC) provider in Sacramento. At the same time, his wife was listed as a one-third owner of Altamedix, Inc. On behalf of Altamedix, BALYASNY prepared documents used to support bills submitted to the Medi-Cal program by Altamedix. Under the Medi-Cal regulations, ADHC providers such as Altamedix were only entitled to Medi-Cal reimbursement for services provided to patients for whom probable institutionalization would be required if adult day health care were not available. In order to obtain Medi-Cal reimbursement for Altamedix, BALYASNY routinely altered patient records to make it appear that patients were sick, could not walk, or could not feed or dress themselves when in fact such statements were not true.

For example, BALYASNY acknowledged that there was a specific patient in 2004 for whom Altamedix had falsely billed Medi-Cal, submitting false documents indicating that the patient had, among other things, chronic headaches, chest pains, shortness of breath, senile dementia, and needed supervision with walking. The investigation, however, revealed that the patient did not suffer from the alleged maladies and in fact, the patient, who had been a medic in World War II, frequently took nature walks on his own for leisure activity.

In a parallel civil case, the Altamedix facility and its owners have agreed to pay the government $450,000 to settle the civil case, but deny any wrongdoing or liability.

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