Attorney General Files Felony Charges Against 16 Individuals Accused of $11M in Medi-Cal Fraud
Attorney General Bill Lockyer (D) Wednesday filed 104 felony charges against 16 individuals who allegedly defrauded Medi-Cal for $11 million by "charging for fake tests at fly-by-night laboratories" -- one the "most egregious Medi-Cal fraud cases in recent years," the Orange County Register reports (Saar, Orange County Register, 6/27). According to the Office of the Attorney General, between 1997 and 2000, the defendants purchased 13 clinical labs in Los Angeles, Riverside and Orange counties that test blood and urine for doctors who treat Medi-Cal and Medicare beneficiaries. The labs allegedly "dramatically increased" their Medi-Cal and Medicare reimbursements through "fraudulent claims that involved the unauthorized use" of the names of more than 24 physicians and stolen Medi-Cal provider numbers. The labs allegedly submitted claims for services that they never performed and tested the blood of illicit drug users and homeless individuals "obtained via black market sources" to "manufacture a facade to mask their criminal enterprise." In addition, the labs often "billed and shut down quickly, leaving blood and urine specimens behind," the attorney general's office said (Office of the Attorney General release, 6/26). The Bureau of Medi-Cal Fraud and Elder Abuse in the attorney general's office has investigated the defendants for more than two years. The blood collected by the labs never entered the nation's blood supply, the Register reports (Orange County Register, 6/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.