San Jose Woman Submitted 150 Fraudulent Healthcare Claims

<p>The Santa Clara County District Attorney’s Office has charged a San Jose fraud prevention expert with submitting more than 150 fraudulent healthcare claims for over &dollar;100&comma;000 against her tech company’s health plan&period;<&sol;p>&NewLine;<p>Faranak Firozan&comma;<strong> <&sol;strong>47&comma; faces numerous felony charges&comma; including altering medical records with fraudulent intent and preparing false statements in connection with insurance claims&period; She also faces an Aggravated White-Collar Crime Enhancement&period; Firozan will be arraigned on July 15&comma; 2025&comma; in Department 23&comma; at 1&colon;30 p&period;m&period;&comma;<strong> <&sol;strong>at the Hall of Justice in San Jose&period; If convicted&comma; she could face years in prison and would be ordered to pay any outstanding restitution&period;<&sol;p>&NewLine;<p>Firozan was a senior manager of privacy and security at NVIDIA and regularly spoke as an expert on fraud prevention&period; She is accused of submitting 167 fraudulent claims&comma; many of which were entirely made-up&comma; between November 2020 and January 2024 to NVIDIA’s self-insured health plan&comma; which is administered by Cigna&period;<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;It’s crucial for everyone&comma; especially those who are experts in fraud prevention&comma; to uphold the same standards they promote&comma;” District Attorney Jeff Rosen said&period; &OpenCurlyDoubleQuote;We are grateful for our partners in this investigation that brought this serious matter to light&period;”<&sol;p>&NewLine;<p>Firozan’s scheme was unraveled through subpoenas&comma; provider interviews&comma; and bank records in a joint investigation by the DA’s Bureau of Investigations &lpar;BOI&rpar; and the California Department of Insurance &lpar;CDI&rpar;&period;<&sol;p>&NewLine;<p>In August 2024&comma; CDI received a suspected fraudulent claim referral from Cigna&period; Firozan had been flagged previously in Cigna’s system in October 2023 after she submitted a large amount of reimbursement claims in one month&period; Many of the claims featured handwritten codes&period;<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;Insurance fraud drives up costs for everyone and erodes trust in the system&comma;” said Insurance Commissioner Ricardo Lara&period; &OpenCurlyDoubleQuote;When someone entrusted with preventing fraud is accused of committing it&comma; that betrayal must be met with accountability&period; I commend our investigators and the Santa Clara County DA’s Office for their strong partnership in this case&period;”<&sol;p>&NewLine;<p>Firozan is accused of altering bills by changing service dates and often fabricating entire documents&period; Providers verified that services listed in her claims were either not performed at all or were duplicated claims&period;<&sol;p>&NewLine;<p>On her LinkedIn page&comma; Firozan described herself as an expert in abuse prevention systems and fraud investigations for financial institutions&period; In 2020&comma; she provided training on cyber laundering for the Information Systems Security Association Silicon Valley Chapter&period;<&sol;p>&NewLine;

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