Federal prosecutors say a California doctor ran a $45 million Medicare fraud scheme, billing for Botox injections that were never medically necessary or never given, then used the proceeds on luxury purchases and vacations while attempting to obstruct investigators.
A jury this week found Violetta Mailyan, 45, guilty in the Central District of California for orchestrating an extensive fraud that targeted Medicare. The indictment says she submitted thousands of false claims for Botox injections and then altered medical records to cover her tracks when investigators closed in.
Mailyan ran Healthy Way Medical Center, a clinic that presented itself as a beauty and cosmetic practice but billed Medicare for treatment of chronic migraines. Medicare does reimburse Botox injections for documented chronic migraine cases, but prosecutors say many of Mailyan’s claims were for cosmetic purposes, for patients without referrals, or for injections that never happened.
The Health Care Fraud Section’s Data Analytics Team flagged the case after its analysis showed that Medicare paid the defendant more for Botox injections than any other doctor in the United States. “Violetta Mailyan falsely diagnosed patients, fraudulently billed for Botox injections while she was actually on lavish vacations, and tried to trick federal agents with fake records,” said Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division. “The Fraud Division’s data-driven approach will shine a light on fraud schemes across the country, ensuring that no doctor can engage in these types of brazen schemes to rob Medicare.”
The trial laid out specific examples of the alleged scheme. Prosecutors say Mailyan billed for injections while she was on vacation in Cabo, Mexico; Maui, Hawaii; Las Vegas; Pennsylvania; and New York, and even billed for a Medicare beneficiary who was incarcerated in federal prison at the time.
Evidence introduced at trial also showed she billed for thousands of injections, representing over $19 million, on dates when her clinic was closed. Investigators say she backdated claims to make it appear injections occurred before patients ever contacted the clinic and fabricated patient consent forms and medical notes to create a record of chronic migraine treatment.
Acting Deputy Inspector General for Investigations Scott J. Lampert of the Health and Human Services Office of Inspector General said the conviction was a warning to others: “Let this conviction serve as a warning: anyone who leverages their medical authority to defraud Medicare will be caught and held accountable.” The government presented documents and witness testimony that prosecutors say prove the altered records were intended to mislead federal agents during the investigation.
“Physicians who defraud and manipulate federally funded health care programs to line their own pockets do so at the expense of American taxpayers and those who are in legitimate need of medical procedures,” said Assistant Director in Charge Patrick Grandy of the FBI’s Los Angeles Field Office. “The FBI is gratified that the jury convicted Dr. Mailyan based on the evidence, which uncovered the largest Botox fraud scheme in the United States, to include brazenly billing for someone who was incarcerated. Furthermore, the FBI is committed to pursuing physicians and others in the healthcare system who fleece Medicare and, in doing so, drive up premiums and co-payments for law-abiding citizens.”
Prosecutors say Mailyan siphoned the fraud proceeds into a lavish lifestyle and collectible purchases. The case record notes expenditures on vacations in Mexico and Hawaii and luxury items such as a $12,000 17th century crossbow and a $3,000 painting, among other purchases tied to the scheme.
The Department’s analytics showed Mailyan as an extreme outlier: at one point she had been paid more than $24 million over the previous four years, roughly six times what the next highest group of providers received, all of whom were neurologists. Prosecutors argued that this outlier status was explained not by legitimate medical practice but by a pervasive and long-running fraud.
After the guilty verdict, a forfeiture finding named several assets as proceeds of the fraud, including a Tesla Model X, a Tesla Cybertruck, $251,124 in bank funds, brokerage accounts valued at $7,312,037 at the time of seizure, and four properties in Surfside and Glendale, California, with combined estimated equity of $7,343,636. Mailyan was convicted on nine counts of wire fraud and three counts of obstruction of a criminal investigation of a health care offense.
Sentencing is set for September 10, 2026, and each count carries statutory maximum penalties: up to 20 years for each wire fraud count and up to 5 years for each obstruction count, with the final sentence to be determined by the judge after considering sentencing guidelines and statutory factors.
Trial Attorneys Sandor Callahan and Jeffrey A. Crapko of the Criminal Division’s Fraud Section prosecuted the case, with the FBI and the Health and Human Services Office of Inspector General investigating. Assistant U.S. Attorney Tara Vavere of the Central District of California’s Asset Forfeiture and Recovery Section is handling the seized assets and forfeiture matters.
The prosecution is presented by officials as an example of how data-driven investigations can uncover health care fraud. The Department of Justice recently stood up a Fraud Division and the broader enforcement effort aligns with a government task force focused on eliminating fraud, waste, and abuse in federal benefit programs.
The Health Care Fraud Strike Force Program, which now operates in multiple federal districts, has charged thousands of defendants over the years and alleges collective billing totals in the tens of billions. Federal agencies including Centers for Medicare & Medicaid Services and the Office of Inspector General continue to coordinate efforts aimed at identifying and prosecuting providers who abuse federally funded health programs.
