Over 100 arrested in California health care fraud crackdowns by DOJ and state AG
Federal and state prosecutors in California arrested over 100 people in separate health care fraud operations, targeting $2 billion in bogus claims to Medicare and Medi-Cal.
California health care fraud sweeps net more than 100 arrests, $2 billion in alleged theft
Federal and state authorities in California have arrested more than 100 people in two separate health care fraud crackdowns announced Thursday, nbclosangeles.com reports, with prosecutors alleging schemes totalling billions of dollars against government and private insurance programmes.
The U.S. Department of Justice announced a federal operation in the early morning hours, charging 15 individuals — including a cardiothoracic surgeon — with collectively stealing $2 billion through fraudulent claims for sham substance abuse treatments, hospice services and other procedures billed to Medicare and private insurers.
Among those charged by federal prosecutors are Dr. Harold Tabaie, 78, and his business partner, chiropractor Hany Malek, 61, both operating Los Angeles-based clinics. The pair allegedly extracted $135 million from Medicare by performing an invasive plaque-clearing procedure on patients who did not need it and repeating the operation on those he had already treated unsuccessfully. Malek is accused of posing as a medical doctor to diagnose patients and recommend the surgery, federal investigators said.
Also under federal indictment are father-and-son duo David Young and Nathan Young, both of Los Angeles. Prosecutors allege the pair ran a years-long scheme to traffic vulnerable patients from across the country to Southern California to receive sham substance abuse treatment, billing private insurance companies for more than $1.6 billion — described by officials as the largest such fraud of its type on record.
The Youngs allegedly controlled dozens of purported substance abuse treatment companies in the Los Angeles area and directed so-called body brokers to target homeless people and addicts attending 12-step programmes. Prospective patients were reportedly lured with offers of free flights, money, apartments, hotel stays, cars, gift cards, marijuana, cigarettes and both illegal and prescription drugs dispensed by doctors employed by the Youngs, according to the indictment filed in Los Angeles federal court.
In a separate announcement, California Attorney General Rob Bonta said his office had arrested and charged 103 people for allegedly defrauding Medi-Cal, California's Medicaid programme primarily serving low-income residents, and collectively stealing $4.5 million. Those charged are accused of filing false bills and lying about care hours for patients who were hospitalised or in nursing facilities rather than at home, under the state's In-Home Supportive Services (IHSS) programme for the elderly and disabled.
"While the alleged fraud represents a small fraction of California's $30 billion IHSS budget, any abuse of Medi-Cal jeopardises funding for our most vulnerable residents," Bonta said in a statement, adding that the state has taken "a firm stand to investigate, prosecute, and shut down Medi-Cal fraud wherever it exists."
The DOJ has previously labelled Southern California a "high-risk environment" for health care fraud, and enforcement activity in the region has intensified under the Trump administration.
"Our message is simple: if you steal health care dollars from the American taxpayer or abuse your position to harm patients, we are coming for you, and the data will lead us to you," said Assistant Attorney General Colin M. McDonald of the Justice Department's National Fraud Enforcement Division.
Source: Google News MT — Crime (en)