20 arrested in $4.6 million Medi-Cal case involving disabled

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Personal Injury News

Article Date: 7/9/2009 | Resource: MLG

20 arrested in $4.6 million Medi-Cal case involving disabled

“Arrests among 42 people named in federal grand jury indictment after 2-year probe.”

Twenty people in Orange, Los Angeles and Riverside counties were arrested today after being accused of participating in a $4.6 million Medi-Cal fraud case that used unlicensed individuals to provide care to about 75 disabled patients, including children with cerebral palsy, prosecutors said.

The arrests were among 42 people named in a federal grand jury indictment returned last month after a two-year probe called “Operation License Integrity,’’ according to U.S. Attorney’s office spokesman Thom Mrozek.

Prosecutors believe the scheme is to be the largest Medi-Cal fraud case ever filed regarding the number of defendants.

The indictment alleges the defendants schemed to bill Medi-Cal about $4.6 million for in-home licensed services – though the service was actually provided by unlicensed individuals, according to Mrozek.

A registered nurse, Priscilla Villabrosa, is accused of being the scheme’s mastermind. Villabrosa, who ran a Santa Fe Springs-based company called Medicare Plus Home Health Providers, had pleaded guilty last year to five counts of health care fraud, prosecutors said.

She hired people from 2004 to 2007 to provide care to disabled patients, and then billed Medi-cal as if they were licensed vocational nurses, prosecutors said. Some of those hired had no medical training, and were told to lie about their qualifications to patients, prosecutors add.

Authorities say some of the patients complained that the “nurses” lacked basic skills, prosecutors said. In one case, a “nurse” was not able to replace a child’s tracheotomy tube, prosecutors said.
Villabroza’s assistant, Susan Bendigo, was indicted in the scheme last year, prosecutors said. She is a fugitive who fled the country during the probe.

The names of defendants weren’t immediately available, but they are all charged with conspiracy to commit health care fraud, as well as health fraud.

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Jeffrey Marquart