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Nine Suspects Arrested in Medi-Cal Fraud Scam
Tribune Weekly Chronicle
Attorney General Edmund G. Brown Jr. today announced the arrests of nine people in a San Bernardino County Medi-Cal fraud case in which employees of a skilled nursing facility and their associates falsified documentation and "callously stole" more than $150,000 from patients and their families for their own personal use.
"This scam ripped off both senior citizens and our desperately needed public health funds," said Brown. "These thieves callously stole thousands of state dollars meant to be spent on seniors in this skilled nursing facility."
The investigation was launched in January by the Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse after an initial investigation by the state's Department of Health Care Services.
Brown's office charged employees and associates at Community Extended Care Hospital of Montclair with committing Medi-Cal fraud in order to steal assets from the trust accounts of elderly patients, which were held by the facility.
From 2006 to 2009, several employees of the extended care hospital conspired with a former San Bernardino County employee who fraudulently submitted documentation to the Medi-Cal program so that Medi-Cal would pay the entire monthly bill for more than 50 patients in the facility.
Then the conspirators told patients and their families they were required to pay a share of the cost of their care directly to the facility. The payments made by the patients and their families were then placed in patient trust accounts, and the suspects took that money for their own personal gain.
The scam involved hospital employees writing checks, ranging from $250 to $6,900, from the patient accounts to individuals in the gang, including a UPS driver, their own relatives, and a next door neighbor, who would then cash the checks, take a percentage of the stolen funds and return most of the cash to the hospital employees. The checks were approved by officials at the hospital.
Nine suspects were arrested this morning and are now in custody at San Bernardino County Jail. Bail was set for $1 million on each defendant. One suspect, Maribel Velazquez, is still at large.
The ten individuals charged in the crime are:
"Our anti-fraud partnership with the Attorney General's Office has once again helped protect our most vulnerable citizens and ensure that valuable Medi-Cal funds are used for their intended purpose," said Karen Johnson, Department of Health Care Services Chief Deputy Director. "We will continue our coordinated efforts as we work to prosecute offenders to the fullest extent allowed by law."