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ASCs in the news: Two more indicted in California medical insurance fraud

Ambulatory Surgery Reimbursement Update, July 15, 2008

An attorney and an accountant are the latest to face charges in an alleged medical insurance fraud involving the Unity Outpatient Surgery Center in Buena Park, California, the Los Angeles Times reports. A total of 19 physicians, administrators, recruiters and others have now been charged by an Orange County grand jury. The article says that six of the 17 other defendants pleaded guilty, and received sentences ranging from probation to 12 years in prison. The surgery center has closed.

The scheme recruited more than 2,000 patients from around the United States to have unnecessary procedures, including colonoscopies and endoscopic procedures, the article reports. Orange County prosecutors charge that defendants gave the patients cash, vacations and cosmetic surgery. The participants billed approximately $154 million in fraudulent claims, according to the charges. The Times says that the latest indictments were for money laundering, filing false tax returns and related charges.

“This case represented greed in its worst form—people gambling with health in the name of cash,” says a statement from Orange County District Attorney Tony Rackauckas, JD. He also says the physicians involved acted like “real-life body snatchers.”

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