Four outpatient surgery centers in the Los Angeles area were raided by the FBI and other law enforcement agencies, according to the National Health Care Anti-Fraud Association. The raids are part of a 15-month investigation into what is being called one of the biggest health insurance frauds ever, said Bill Mahon, president of the antifraud group. The ongoing probe involves dozens of clinics and more than 100 providers in Southern California, which insurers and employers say have bilked them out of $300 million to $500 million in recent years, Mahon said. The clinics allegedly lured thousands of patients from around the country with cash rewards, performed medically unnecessary surgeries on them and then overcharged insurers for the out-of-state, out-of-network procedures, he said. Several large self-insured employers and most leading insurers, including Cigna Corp., UnitedHealth Group and Blue Cross and Blue Shield plans nationwide, have been affected. "Every state in the country has been hit by this," Mahon said. While a number of different groups are involved, investigators suspect the groups may be loosely connected or have branched out from several original groups. The clinics that were served search warrants, Mahon said, are Millennium Outpatient Surgery Center in Fountain Valley and Santa Ana; Bel Air Surgical Institute, Los Angeles; and Valley Multi-Specialty Surgery Center, Reseda. -- by Laura B. Benko
Surgery centers raided in insurance fraud probe
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.
Recommended for You