Medical fraud, specifically fraud against Medicare and various insurers, may be a tempting target because the financial resources appear to be almost unlimited and because the enormous bureaucracy makes discovering theft and identifying the perpetrators of the fraud very difficult. However, as a recent case from Orange County demonstrates, an initial success may lead investigators to a person who is attempting to defraud the system on a large scale.
The defendant in the case was an anesthesiologist who worked in Beverly Hills. He was recently sentenced to 10 years in prison after pleading guilty to eight counts of insurance fraud and two aggravated white collar crime enhancements. The Orange County District attorney said that the defendant recruited so-called “body brokers” to hire persons with no apparent illness to submit to medically unnecessary naltrexone implant surgeries and cortisone shots.
The prosecutors said that the defendant also billed several insurers for unnecessary procedures performed on drug-addicted patients. The defendant sent many patients to laboratories in Los Alamitos, CA, for unnecessary tests. The laboratories were owned by a woman with whom the defendant was having a romantic relationship.
In addition to being sentenced to 10 years of incarceration, the defendant was ordered to pay $9.1 million in restitution. The woman who ran the labs in Los Alamitos pled guilty to two felony charges of insurance fraud and was sentenced to one year of home confinement.
The Orange County District Attorney said that the defendant used vulnerable and sober individuals as his own ATM machine, not caring about his patients’ welfare.
Solid advice from a criminal defense attorney
The defendants in this case were charged with having committed serious crimes. Anyone facing similar charges may benefit from consulting an experienced criminal defense attorney for a useful evaluation of the evidence, a suggestion of potential defense strategies, and where appropriate, assistance in negotiating an acceptable plea agreement.