For allegedly billing Anthem Blue Cross for a prosthetic arm worth $170,000 after the patient to receive it had died, Am-Pro Prosthetics & Orthotics CEO Peter Lira was arrested on three felony counts of insurance fraud.
Anthem Blue Cross suspected deceit so the claim was referred to the California Department of Insurance. Investigators from the department discovered that Lira purportedly filed falsified invoices and forged the signature of the deceased on the delivery receipt to collect payment for manufacturing the prosthetic arm, despite the patient passing away.
Nancy Kincaid, spokeswoman for the Department of Insurance, revealed that the patient previously worked as a public defender in Los Angeles County. “He passed away from cancer when Lira was in the process of making a prosthetic arm for him, so Lira allegedly falsified records and said the arm was for someone who had been in an industrial accident. But he used the same person’s name,” she added.
Lira was arrested October 30 and incarcerated in Men’s Central Jail in Los Angeles. If convicted on all counts, he faces five years in prison. The Los Angeles County District Attorney’s office is prosecuting the case.
“He bailed out the same day he was arrested and he was on probation for domestic violence,” Kincaid revealed. She also said that the department sees a lot of insurance fraud cases involving health care providers, and that health insurance fraud is a billion-dollar problem that far outpaces all other types of insurance fraud.
Lira is scheduled to appear on November 18 in Los Angeles Superior Court.
