Billed for translation services that weren't necessary or didn't take place
LOS ANGELES- On December 17, 2015, detectives with the California Department of Insurance (CDI) arrested nine people in Southern California who are suspected in a complex scheme targeting more than 230 workers' compensation insurers and self-insured employers.
Siblings Francisco Javier Gomez, Jr., 32, and Angela Rehmann, 38, owners of G&G Interpreting Services, allegedly fraudulently billed more than $24.6 million for interpreting services for injured workers with Latino surnames.
According to Department of Insurance detectives, over a four year period G&G Interpreting allegedly billed for translation services provided to clinics where the majority of the clinic staff spoke Spanish and there was no need for translation services. In other cases, the company billed for services to clinics where 13 treating physicians spoke fluent Spanish-and again-there was no need for translation.
"People often make the mistake of thinking insurance fraud is a victimless crime-it is not," said Insurance Commissioner Dave Jones. "When those providing services to injured workers line their pockets by ripping-off workers' compensation insurers through fraudulent overbilling practices and charging for services that never occurred, we all end up paying."
G&G Interpreting had a substantial operation providing Spanish-language interpreting services across the Los Angeles Basin and Southern California for injured workers receiving healthcare services through the workers' compensation system.
The investigation revealed that 83,411 interpreting service events exceeded 12 hours in a day-more hours than the clinics were actually open. Detectives also discovered that G&G Interpreting billed workers' compensation insurers more than $422,000 for the services of an interpreter who was actually incarcerated in state prison during the time the company claimed she was providing interpreting services; in fact, she is still in state prison.
"CDI detectives work very complex investigations that take time, dedication and perseverance," said California Statewide Law Enforcement Association (CSLEA) President Alan Barcelona. "Insurance fraud is a huge problem in this state, fortunately we have some of the very best, tackling it head-on."
The arrest operation was conducted by the Department of Insurance with assistance from the California Highway Patrol and the Riverside County District Attorney's Office and San Bernardino District Attorney's Office. The case is being prosecuted by the Los Angeles County District Attorney's Office. This investigation is ongoing.
Suspects arrested:(top row from left to right)
Amber Anguiano, 28
Angela Rehmann, 37
Arnulfo Reyes III, 22
Crystal Garcia, 21
(Bottom row from left to right)
Cynthia Gomez, 30
Francisco Javier Gomez, Jr., 32
Gloria Sandoval, 41
Jamilett Ortega, 33
Melissa Navarro, 28