SAN JOSE - A doctor and an unqualified medical interpreter were arraigned in early June on felony fraud charges for conspiring to bilk insurance companies out of thousands of dollars by billing for translation services that were illegal or non-existent.
Charged were Dr. Tariqu Mirza, 60 of Union City and Gabriela Pacheco, 46, of San Jose. Dr. Mirza is the owner of Ariba Healthcare Group Inc., providing medical and chiropractic treatment with offices in San Jose and the greater Bay Area. The clinics primarily treat patients in the workers’ compensation system. Pacheco is the owner of One World Interpreting Services, a San Jose company that provides Spanish translation services for medical providers.
According to the investigation, in some cases, Pacheco allegedly substituted her unqualified family members to provide translation services, which are required by state law to be done by a certified interpreter. In other cases, Pacheco allegedly billed companies for patients with Latino surnames for which she hadn’t done any work at all. Dr. Mirza allegedly helped organize the scam and received kickbacks, according to the charges.
Mirza and Pacheco were charged with conspiracy to commit workers’ compensation billing fraud and unlawful kickbacks for patient referrals. If convicted, they face time in prison.
“There’s a reason you have to be certified to do these translations,” prosecutor Julie Sousa said. “Injured workers are entitled to a standard level of care – which includes qualified interpreters to translate everything from their surgery risks to medication instructions.”
The scam fell apart when the Santa Clara County District Attorney’s Bureau of Investigation initiated an investigation which revealed that Pacheco was billing more than 100 insurance companies, claims administrators and self-insured employers despite being unqualified under the California Code of Regulations. The Bureau requested assistance from the Franchise Tax Board (FTB). An FTB agent examined thousands of records which uncovered more than $100,000 of kickbacks from Pacheco to Mirza through payments made to third parties.
“FTB agents are a great resource for local and federal law enforcement officers,” said CSLEA President Alan Barcelona. “They also team with other state investigators from various department to uncover criminal acts that might otherwise go undetected.”
In 2017, DA investigators discovered that Mirza submitted written reports to at least six insurance companies falsely identifying Pacheco as a “licensed interpreter.” A search of Pacheco’s home business revealed more than a thousand patient files containing medical information, in violation of medical record privacy laws.