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Orange County Insurance Fraud Investigations


Orange County Insurance Fraud Investigations

Sunny and beautiful Orange County, California is home to a large senior citizen population. A vast majority of these senior citizens utilize federal health insurance programs like Medicare and Medicaid. Medicare and Medicaid are funded by taxpayer dollars and provide free or reduced-cost medical services to elderly persons in need. To qualify, you generally need to meet certain age and income requirements. While many individuals may guess that hospitals, doctors, and nursing homes look down on federally funded health care, this is not the case. In fact, health care providers actively advertise their services to individuals enrolled in Medicare and Medicaid. Why? Because Medicare and Medicaid guarantee payment. Unlike individuals with inadequate private insurance and a questionable ability to pay out-of-pocket, Medicare and Medicaid provide health care providers with easy means of obtaining reimbursement.

Due to the ease of the system and the guarantee of timely payment, Medicare and Medicaid insurance fraud are commonly prosecuted in Southern California, including Orange County and Los Angeles. For instance, the U.S. Department of Justice recently obtained a conviction for a Los Angeles owner of a medical equipment supply company that defrauded Medicare of $4 million. As part of his scheme, Valery Bogomolny sold mobility assistance equipment like braces and power wheelchairs to clients who were fully capable of walking on their own. In addition, Bogomolny filed false Medicare claims that alleged that he had delivered power wheelchairs to customers when in fact no equipment had been given to customers.

By intentionally lying on his Medicare billing forms, Bogomolny committed health insurance fraud. These false claims were coupled with fraudulent documentation, such as bogus home inspection reports that stated that mobility assistance was necessary. These false claim requests amounted to approximately $4 million, and $2.7 million of that had already been received by Bogomolny. Bogomolny was convicted after trial and now awaits sentencing in Los Angeles.

In nearby Riverside, California, the Alta Vista Healthcare & Wellness Centre was raided by the FBI on October 22, 2015. Pursuant to a search warrant, FBI agents swooped in to the surprise of local residents at the 99-bed nursing home. No patients were affected by the search, but the FBI did uncover and confiscate evidence. According to the Sacramento Bee, which conducted an investigation into the matter, the facility is owned by Schlomo Rechnitz, a Los Angeles nursing home mogul who owns approximately 80 facilities throughout California. Rechnitz's properties are accused of three times as many violations as the average California nursing home. This is not the first time Rechnitz's facilities have come under scrutiny. In fact, in Orange County, several employees were arrested for abusing residents and failing to report abuse. These two employees worked at the Mesa Verde Post Acute Care Center, though they were no longer working for the facility at the time of the arrest. Another facility in Montrose, Verdugo Valley Skilled Nursing & Wellness Centre, was also involved in a felony elder abuse scandal in August.

If you were accused of elder abuse or your organization was accused of defrauding the federal government through false Medicare or Medicaid claims, it is vital that you contact an aggressive and experienced federal criminal defense lawyer who specializes in white collar crimes. A skillful litigator can assist you with:

  • Protecting your assets
  • Complying with discovery requests and search warrants
  • Investigating abuse and fraud committed by employees
  • Protecting your constitutional rights
  • Managing your reputation
  • Negotiating with prosecutors and federal authorities
  • Aggressively and zealously defending your case in court

Health insurance fraud in Orange County is vigorously investigated and prosecuted by state and federal law enforcement. To defend yourself and your company, contact Scott D. Hughes, Attorney at Law, now at (714) 423-6928 to schedule a free case review.

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