MEDI-CAL FRAUD: South Bay Clinic Owner Gets Prison Term
A South Bay medical clinic owner was sentenced Monday to five years in prison for bilking the Medi-Cal health care plan with phony medical claims, the Los Angeles Times reports. State officials said that Annilie Ferrer and her business partner Eric Chan set up a "multimillion-dollar fraud mill" that submitted $1 million in phony billings. The scheme comes on the heels of another scam in which officials suspect the pair "defrauded the state of at least $2 million" through another clinic. Ferrer pleaded no contest and was sentenced on 21 counts of fraud, grand theft and conspiracy for both cases. "What (Ferrer) learned from the first case was basically to do the paperwork better. It's not so obviously faked up ... the level of duplicity in this case is extremely unusual," Deputy Attorney General Malcolm Venolia said. Investigators seized more than $445,000 from the defendants' bank accounts, and Ferrer was ordered Monday to pay restitution up to $3 million. The case is one of the latest in a "broad government crackdown" on Medi-Cal fraud, launched by Gov. Gray Davis (D) and the FBI. The Times reports that most offenders end up with plea bargains with "little or no prison time" -- which may explain why Ferrer and Chan continued fraud operations while already facing criminal charges. In court, Venolia told Judge Jacqueline Conner, "I think until a severe sentence is handed out, these defendants will say: 'Hey, the sentence will be light. Why not keep stealing?'" (Mozingo, 2/8).
In other fraud news, a former billing manager for a San Diego medical group has been indicted by a federal grand jury for cashing and depositing phony medical claims totaling $75,116, the San Diego Union-Tribune reports. Ronald Casson was arraigned Friday for 60 counts of embezzlement "in connection with health care, false statements related to health care matters and criminal forfeiture." Assistant Attorney General Edward Allard said that Casson submitted 21 fraudulent claims to private insurance companies while working for Coast Urology Medical Group between December 1997 and July 1998. Allard noted that Casson used the money to buy a 1989 Porsche 911, which was later seized by agents. Casson is being held on a $40,000 bond (Taylor, 2/8).