Five Charged in $580M Southern Calif. Hospital Kickback Scheme
Last week, the U.S. attorney's office announced that federal authorities have charged five people in an alleged kickback scheme involving $580 million in improper claims by Southern California hospitals, AP/KQED's "The California Report" reports.
Details of Charges
In one case, dozens of physicians, chiropractors and other providers were given illegal kickbacks for referring patients to Pacific Hospital of Long Beach for spinal procedures.
In a statement, the U.S. attorney's office said, "Some of the patients lived hundreds of miles away from Pacific Hospital and closer to other qualified medical facilities," adding, "The patients were not informed that medical professionals had been offered kickbacks to induce them to refer the surgeries to Pacific Hospital."
In a separate case, the Department of Justice said physicians were paid illegal kickbacks for referring patients to Tri-City Regional Medical Center in Hawaiian Gardens for spinal surgery.
According to prosecutors, the fraudulent payments in the two schemes led to the improper submission of more than $580 million claims over eight years, many of which were paid by the California worker's compensation system and the federal government.
According to prosecutors, two of the people charged already have pleaded guilty, while three others have agreed to do so ("The California Report," AP/KQED, 11/25).
In a statement, California Insurance Commissioner Dave Jones (D) said, "Injured workers were treated like livestock by doctors and hospitals who paid or accepted kickbacks and bribes in exchange for referrals" (DOI release, 11/24).
Meanwhile, U.S. Attorney Eileen Decker in a separate statement said, "The members of this scheme treated injured workers and their spines as commodities, to be traded away to the highest bidder," adding, "This investigation should send a message to the entire industry: patients are not for sale" (Usheroff, Los Angeles Business Journal, 11/24).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.