A five-year investigation has uncovered a widespread insurance scam in Los Angeles County that has bilked more than $150 million from health insurers and endangered the life and health of patients.
According to a Wednesday report from the LA Times,
Dr. Munir Uwaydah, his attorney and more than a dozen associates stand accused of perpetrating one of the largest insurance scams in state history.
Using referrals from attorneys and others, Uwaydah’s clinics received up to $10,000 a month to treat patients with expensive tests and unnecessary medical procedures.
Physicians affiliated with Uwaydah documented medical evaluations, including MRIs, that never occurred in order to justify expensive orthopedic surgeries. In many cases, the operations were performed by physician’s assistants who never attended medical school, leaving scars and other significant damage to patients who didn’t need surgery in the first place.
“All 21 patients sustained lasting scars and many required additional surgeries and suffered physical and psychological trauma as a result of their experience in Uwaydah’s clinics,” prosecutors said in a news release.
The operations were then billed to insurers as “surgeon’s work,” allowing Uwaydah and associates to collect more than $150 million in insurance money.
It stands as an expensive and particularly egregious lesson in how insurance fraud negatively affects both victims and the market as a whole.
“Although the patient victims sustained physical harm, we who pay higher premiums for healthcare suffer economic harm when scams are allowed to continue unchecked,” said District Attorney Jackie Lacey.
The Los Angeles District Attorney’s Office did not disclose how it uncovered the fraud, but did say it was the result of a five-year probe that involved employees going undercover as patients.
Uwaydah and 14 other defendants, including his billing manager and the physician’ assistant that performed the surgeries, face 132 felony indictments. Among these charges are conspiracy, insurance fraud, aggravated mayhem and capping.
If convicted, the defendants face sentences up to life in prison.