Charges in Health Insurance Fraud Scheme
July 8, 2020
by Sean Weiss, Partner & VP of Compliance
Once again, a physician and his associate(s) believed they were smarter than the governmental investigators only to be shown they were not. In this case, a Beverly Hills Surgeon and his Girlfriend have been charged with stealing nearly $52 Million in an elaborate insurance fraud scheme that preyed on sober living patients. Four others are facing multiple felonies in connection with identifying patients to undergo medically unnecessary surgeries and procedures to bilk insurance companies!
This case is appalling! The lengths some will go to cannot be overstated and the fact they preyed on the vulnerable is reprehensible!
It should be noted the defendants pled not guilty and as such they are innocent until proven guilty in a court of law. The doctor pleaded not guilty to 88 felony counts in two separate cases in connection with recruiting and hiring numerous body brokers to find and pay patients to have medically unnecessary surgeries. It is alleged that the patients underwent unnecessary drug tests which he sent to a laboratory, which is owned by his girlfriend, for testing.
Sean M. Weiss is a Partner and serves as VP/Chief Compliance Officer for DoctorsManagement, LLC based in Knoxville, TN. DoctorsManagement, LLC services more than 20,000 clients nation-wide and has been in existence since 1956. Weiss serves as an Investigator and expert witness in Federal and State cases as well as an expert or lead in Administrative Law Judge Hearings. During his 25-year career, Weiss has engaged in more than 200 cases working with law firms and health systems across the country. Weiss serves as a third-party compliance and regulatory officer for more than a dozen health care organizations across the country of varying sizes. For more information on Sean M. Weiss or DoctorsManagement, LLC visit us online at www.doctors-management.com or contact us directly at 800.635.4040. You can also follow Sean on his biweekly Blog on LinkedIn (Sean M. Weiss “The Compliance Guy”) or at www.thecomplianceguyblog.com
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