Corporate Compliance

Doc pleads guilty to performing unnecessary surgeries in "rent-a-patient" scheme

Compliance Monitor, July 18, 2007

A Los Angeles doctor pleaded not guilty to charges of bilking insurance companies by arranging unneeded surgeries with the cooperation of patients last week, the Associated Press (AP) reports.

Dr. Mamdouh Bahna, 58, who entered his plea in federal court, was taken into custody January 1 at Los Angeles International Airport upon returning from Egypt, where he had fled after being indicted three months prior, according to the news report.

Prosecutors say Bahna hired workers to recruit people with health insurance to undergo unnecessary surgery in exchange for cash or discounts on plastic surgeries. Payments allegedly ranged from $300 to $1,200 for such procedures as colonoscopies, sinus surgeries and an operation meant to stop palms from sweating.

According to the indictment, recruiters told the patients to describe false and exaggerated symptoms, which were then used to make the surgeries seem justified. Charges to insurance companies totaled at least $3.9 million, with $1.1 million paid out.

The case grew out of a federal investigation of Southern California outpatient surgery centers that allegedly overbilled insurers for unnecessary surgeries, the AP states.

Since the "rent-a-patient" scheme was first identified several years ago, insurers nationwide have been fraudulently billed hundreds of millions of dollars, experts say.

Most Popular