It was a $154 million medical insurance fraud scheme and our members' intense work as investigators for the state of California is paying off. The defendant's (an accountant, an attorney, three doctors and patient recruiters) are going prison.
"This was an elaborate scheme that involved 19 defendants. Some have referred to this as 'the body snatchers,'" said California Statewide Law Enforcement Association (CSLEA) President Alan Barcelona. "It's the largest medical fraud case in the country and our CSLEA members who are state investigators put a stop to it."
The scheme involved the Unity Outpatient Surgery Center in Buena Park and the recruitment of thousands of healthy people (patients) to undergo unnecessary and dangerous surgeries in which the center fraudulently billed medical insurance companies. Insurance companies paid out more than $20 million over a 9-month period.
On January 11, 2013, two surgery center administrators were sentenced. Dee Francis, 63, was sentenced to six years in prison and Rosalinda Landon, 67, was sentenced to five years, four months in prison.
Prosecutors said it was an elaborate scheme in which 2,841 healthy people from all over the country were recruited to have unnecessary surgeries and that Unity billed insurance companies for more than $154 million in fraudulent claims. Three doctors are charged with performing the surgeries and an attorney and an accountant are accused of helping to keep the center open and operating. Other defendants include those who would recruit patients. Those patients would receive money or minor cosmetic surgeries in exchange for participating.
Three of the defendants, including two doctors, still face a trial and/or sentencing.
The Unity Outpatient Surgery Center was investigated by the California Department of Insurance, California Franchise Tax Board and the Orange County District Attorney's Office.
The Orange County District Attorney's Office has a press release that reads more like a play book. View it here.