The California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse assisted with this investigation
“Submitting false claims for money to public programs is a crime, a violation of trust, and hurts all of us as taxpayers. These types of investigations are often complicated and lengthy and we very much appreciate the law enforcement work that it took to ensure justice is served.”
– CSLEA President Alan Barcelona
RIVERSIDE– On May 7, 2024, the U.S. Justice Department announced that the owner and sole physician at a Bellflower medical clinic has pleaded guilty to submitting millions of dollars’ worth of false claims to a Medi-Cal health care program that provides family planning services to low-income and uninsured patients, causing more than $2.5 million in losses.
Robert Eyzaguirre, 77, of Torrance, pleaded guilty to one count of health care fraud, a felony that carries a statutory maximum sentence of 10 years in federal prison.
According to his plea agreement, Eyzaguirre owned and operated Dr. Robert’s Medical Center, a Bellflower-based medical clinic enrolled as a Family Planning, Access, Care and Treatment (Family PACT) provider run through the Medi-Cal public health program that California administered under Medicaid. At this clinic, Eyzaguirre employed and supervised Gary Lee Didio, 54, of Huntington Beach, and Sandra Rios, 51, of South Los Angeles.
From at least December 2013 through January 2020, Eyzaguirre conspired with Didio and Rios to submit more than $4.6 million in fraudulent claims to the Family PACT program for family planning services that were never provided. Specifically, Rios picked random names from an online phone-and-address directory and created fake patient files, including inserting fake vital signs and patient notes.
Eyzaguirre signed the fake patient files, falsely representing that he had provided family planning services to those patients. Eyzaguirre sometimes signed blank patient forms before the false vital signs and notes had been added. The fake patient files were then submitted to the Family PACT program for reimbursement. The Medi-Cal program paid more than $2.5 million on the fraudulent claims submitted by Dr. Robert’s Medical Center.
Eyzaguirre also falsely certified in the fake patient files that laboratory tests were medically necessary. Didio and Rios then referred the names of fake patients to a laboratory in Northern California, which then paid an illegal kickback of $30 cash for each referral. In total, the laboratory paid more than $372,000 in illegal kickbacks for the referrals of fake Family PACT patients from Dr. Robert’s Medical Center. The Medi-Cal program paid more than $1 million on the fraudulent claims submitted by the laboratory related to the scheme.
When Eyzaguirre learned that law enforcement was investigating the fraudulent scheme, he attempted to conceal the criminal activity by instructing Didio to remove the fake patient files from Dr. Robert’s Medical Center and hide them offsite. Once the files had been moved, Eyzaguirre attempted to shred the fake patient files to prevent law enforcement from discovering them.
Eyzaguirre admitted in his plea agreement to abusing his position of trust as a physician and obstructing justice.
Rios and Didio have pleaded guilty to conspiring to receive illegal remunerations for healthcare referrals. They are expected to be sentenced in the coming months.
United States District Judge Jesus G. Bernal scheduled a sentencing hearing for Eyzaguirre on October 28.
The United States Department of Health and Human Services Office of Inspector General and the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse investigated this matter.
