Twelve Blue Cross and Blue Shield plans sued nine surgery centers in Southern California, seven management companies and 34 individuals for allegedly paying patients to undergo needless and sometimes dangerous surgeries, most often colonoscopy or endoscopy.
Paid recruiters allegedly enlisted patients from more than 40 states to undergo surgeries at the California centers in return for cash or discounts on cosmetic surgery. The so-called "Rent-a-Patient" scheme allegedly began in 1999. Fraud specialists said they believed it was the first major case in which clinics and surgeons paid healthy patients to undergo invasive procedures.
The lawsuit, filed in U.S. District Court in Los Angeles, seeks to recover $30 million in payments. The plaintiffs include Blues plans of Alabama, Massachusetts, Michigan, Nebraska, North Carolina and Tennessee; as well as CareFirst (serving Delaware, Maryland and Washington), Empire (New York), Excellus (New York), Highmark (Pennsylvania), Premiera (Alaska and Washington state), and Regence (Idaho, Oregon and Utah).