A Los Angeles orthopedic surgeon and 14 of his associates were indicted Tuesday for allegedly operating an insurance fraud that netted them $150 million. Prosecutors called the charges against the operators of Frontline Medical Associates the largest and most elaborate such scheme in California’s history.
The doctor and various associates obtained patients by paying kickbacks to marketers and to a workers compensation attorney. They allegedly operated their own MRI business out of a trailer, occasionally altering the results of the MRIs in order to justify surgery.
The group also ran its own pharmacy, exclusively for the practice’s patients, which allegedly over prescribed and over billed insurance companies for pharmaceuticals.
One doctor in the practice who was indicted allegedly billed insurance companies for office visits for which he was not present.
But the “most serious charges,” according to Los Angeles County District Attorney Jackie Lacey, involved the surgeries themselves. The chief doctor in the practice, Munir Uwaydah, and his staff allegedly deceived “nearly two dozen patients into having surgeries thinking they would be done by Uwaydah. In fact, the surgical procedures were performed by a physician’s assistant who never attended medical school,” said a news release from the D.A.
The assistant “operated on patients while they were under general anesthesia and without Uwaydah present in the operating room,” according to the release and the indictment. “All 21 patients sustained lasting scars and many required additional surgeries and suffered physical and psychological trauma” as a result of what they went through.
Most of the names of the victimized patients listed in the indictment were Hispanic.
A five-year investigation produced two indictments, one of 57 counts against Uwaydah and alleged co-conspirators charged with insurance fraud and aggravated mayhem, among other things.
In another 75-count indictment, Uwaydah’s personal lawyer and three others were charged with conspiracy to commit insurance fraud, money laundering, illegal patient referrals and filing false tax returns.
Uwaydah was arrested in Germany and is awaiting extradition to the U.S., according to officials. Eleven of those charged have entered not guilty pleas. Uwaydah, who could not be located for comment, has yet to comment.
According to the Los Angeles Times, Uwaydah was placed on probation for two years by California’s Medical Board for failing to document patient exams and gross negligence while practicing at Tustin Hospital and Medical Center. In 2013, according to the paper, the Medical Board canceled his license, citing prolonged absence from California.
http://www.washingtonpost.com/news/...-surgeries-as-part-of-massive-insurance-scam/
The doctor and various associates obtained patients by paying kickbacks to marketers and to a workers compensation attorney. They allegedly operated their own MRI business out of a trailer, occasionally altering the results of the MRIs in order to justify surgery.
The group also ran its own pharmacy, exclusively for the practice’s patients, which allegedly over prescribed and over billed insurance companies for pharmaceuticals.
One doctor in the practice who was indicted allegedly billed insurance companies for office visits for which he was not present.
But the “most serious charges,” according to Los Angeles County District Attorney Jackie Lacey, involved the surgeries themselves. The chief doctor in the practice, Munir Uwaydah, and his staff allegedly deceived “nearly two dozen patients into having surgeries thinking they would be done by Uwaydah. In fact, the surgical procedures were performed by a physician’s assistant who never attended medical school,” said a news release from the D.A.
The assistant “operated on patients while they were under general anesthesia and without Uwaydah present in the operating room,” according to the release and the indictment. “All 21 patients sustained lasting scars and many required additional surgeries and suffered physical and psychological trauma” as a result of what they went through.
Most of the names of the victimized patients listed in the indictment were Hispanic.
A five-year investigation produced two indictments, one of 57 counts against Uwaydah and alleged co-conspirators charged with insurance fraud and aggravated mayhem, among other things.
In another 75-count indictment, Uwaydah’s personal lawyer and three others were charged with conspiracy to commit insurance fraud, money laundering, illegal patient referrals and filing false tax returns.
Uwaydah was arrested in Germany and is awaiting extradition to the U.S., according to officials. Eleven of those charged have entered not guilty pleas. Uwaydah, who could not be located for comment, has yet to comment.
According to the Los Angeles Times, Uwaydah was placed on probation for two years by California’s Medical Board for failing to document patient exams and gross negligence while practicing at Tustin Hospital and Medical Center. In 2013, according to the paper, the Medical Board canceled his license, citing prolonged absence from California.
http://www.washingtonpost.com/news/...-surgeries-as-part-of-massive-insurance-scam/
