Over a dozen people have been arrested and charged with $1.8 billion in alleged healthcare fraud, according to federal prosecutors. Several of the people arrested were healthcare professionals.
“It is especially egregious when doctors and other health care professionals, who pledged to do no harm, resort to petty greed and criminality,” said First Assistant United States Attorney Bill Essayli in a U.S. Justice Department press release.
“Every dollar drained out of our private and public health insurance systems is one less dollar available to those who truly need it.”
One of the arrests occurred Thursday morning at a hillside mansion in Tarzana, where federal agents arrested 61-year-old Hany Malek.
Malek is allegedly a chiropractor who has posed as a medical doctor and would diagnose patients with arterial diseases and suggest patients should go get an atherectomy, a procedure where they remove plaque from their arteries.
Patients would then go to 78-year-old Dr. Harold Tabaie of Anaheim, a cardiothoracic surgeon. Tabaie would do this surgery multiple times on some patients, saying it was “unsuccessful” the first time. To hide the unusual number of surgeries happening, Tabaie would bill the procedure under the names of other medical providers. The surgeries left patients feeling “extreme pain and discomfort,” according to the press release. The FBI, U.S. Department of Health and Human Services Office of Inspector General, and the United States Marshals Service are investigating this matter.
15 individuals in total were charged, with six of them being medical professionals. These charges include “sham substance abuse treatment programs, unnecessary artery treatments, and bogus hospice services.” Eight of the defendants were arrested just today.
These arrests include father and son, 71-year-old David and 39-year-old Nathan Young, who were in charge of numerous false substance abuse treatment companies in the Los Angeles region and around the country. The two directed other individuals to target and traffic vulnerable homeless populations, people living in poverty, and people already attending substance abuse support groups.
The defendants would lure possible patients by promising them free flights, money, apartments, hotel stays, cars, gift cards, marijuana, cigarettes, and other controlled substances and prescription medications.
Through investigations, it was found that these promises were rarely fulfilled and people didn’t get the treatments they needed.
Once the defendants got a patient, they would be considered “premium” status with high-reimbursing insurance policies and got hotels, dinners, and private apartment stays, while those considered “non-premium” would end up in poorly conditioned living spaces described as “trap houses” that were cramped, unsanitary, and crowded. Patients would get cycled through the Young’s facilities and would knock out patients with drugs if they tried to leave.
The FBI, IRS Criminal Investigation, and the Drug Enforcement Administration are still investigating the case.
Five of the defendants arrested today are expected to make their first court appearances in downtown Los Angeles this afternoon. The three other defendants are to appear in Texas and Illinois federal courts.
The post 15 Charged in $1.8 Billion Healthcare Fraud Scheme appeared first on LAmag.
