California AG Bonta announces felony charges in massive $1.3 million Medi-Cal fraud scheme involving fake light treatments
San Diego, California – A dermatologist in San Diego is in a lot of legal problems after being suspected of defrauding California’s Medi-Cal program out of more than $1.3 million. On Thursday, California Attorney General Rob Bonta said that the doctor would face felony charges. This is part of what investigators call a huge conspiracy that lasted for years and targeted the state’s important health insurance system for low-income individuals.
The California Department of Justice said that the investigation found that the dermatologist allegedly charged Medi-Cal about $1.4 million for procedures that were never really provided. The case is about claims for light therapy sessions, which are meant to heal skin problems. However, officials allege that most of these treatments were never done as reported. In a lot of cases, patients were said to have gotten therapy with non-medical lighting, which makes the claims even less believable.
Officials say that on certain days, the doctor sent bills for more than 200 people, with an average of 60 to 70 patients per day, all for the same or very similar treatments. The size and pattern of the suspected fraud sent off alarms in the system and led to an investigation by both state and federal officials.
“We will not tolerate fraud where individuals take advantage of Medi-Cal to line their own pockets, potentially jeopardizing critical, necessary medical services our most vulnerable residents rely on,” said Attorney General Bonta.
“Today’s action is possible due to my team’s efforts to hold accountable those who defraud Medi-Cal, and we will continue to do so. At the California Department of Justice, we are committed to fighting against all types of elder abuse, theft, and fraud. We will take prompt action to ensure that anyone who exploits or harms these vulnerable members of our community is held accountable.”
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The formal lawsuit, which was filed in San Diego County Superior Court, says that the dermatologist committed 22 counts of healthcare insurance fraud and one case of Medi-Cal fraud. There are also other charges for white-collar crime and excessive takings, which show how serious and widespread the alleged crimes are.
The California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse was in charge of the investigation. The FBI, the California Department of Healthcare Services, and the Office of Inspector General at the U.S. Department of Health and Human Services contributed in the case. The Division gets most of its money from a federal grant. This shows that state and federal authorities are working together to stop fraud and abuse in healthcare programs.
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The case is still ongoing, and officials are asking anyone who knows anything about possible Medi-Cal fraud to come forward. The Attorney General’s office has made it plain that safeguarding public resources and making sure that justice is served for disadvantaged communities are still their top concerns.
