Surgeons Indicted
In conjunction with Hammer’s plea, the feds announced the additional indictments of physicians and others involved in the scheme.
The U.S. Attorney’s Office named Daniel Capen, M.D., Timothy Hunt, M.D., Lauren Papa, D.C., Tiffany Rogers, M.D., William Parker, Brian Carrico, D.C., and two companies Carrico partially owns—Performance Medical & Rehab Center and One Accord Management, Inc. as other defendants accused of playing a part in the scheme.
Capen, Hunt, and Papa have already agreed to plead guilty.
According to prosecutors, Capen, an orthopedic surgeon of Manhattan Beach accounted for about $142 million of Pacific Hospital’s claims to insurers, of which he was paid about $56 million.
Palos Verdes Estates resident Hunt, also an orthopedic surgeon, referred spinal surgery patients to Capen and other doctors.
Papa of Tarzana agreed to plead guilty to a conspiracy charge involving her receipt of illegal kickbacks to refer patients to a neurosurgeon with knowledge that the neurosurgeon would perform the surgeries at Pacific Hospital.
Rogers, an orthopedic surgeon living in Palos Verdes Estates, had not pleaded guilty as of this writing.
Carrico, the chiropractor of Redondo Beach and the two companies he partially owns, were charged in connection with the receipt of illegal kickbacks to influence the referral of patients to Pacific Hospital. Prosecutors allege he and the companies, as well as other co-conspirators, were responsible for $80 million in claims submitted to the federal workers’ compensation program and were paid about $56 million in connection with patients that were referred to Pacific Hospital by Performance Medical.
In a related indictment, three other orthopedic surgeons were charged earlier in June.
David Hobart Payne, M.D., of Irvine, was accused in a grand jury indictment of taking about a $450,000 bribe to direct around $10 million in surgeries to Pacific Hospital.
Lokesh Tantuwaya, M.D., of Rancho Santa Fe and Rock Springs, Wyoming, was accused in an indictment of receiving $3.2 million in kickbacks for directing or performing $38 million in surgeries to the hospital.
Jeffrey David Gross, M.D., of Dana Point, was accused in an indictment of receiving $622,000 for performing or referring $19 million in surgeries to the hospital.
The Last Word – From the IRS
The investigation into the kickback scheme was conducted by the Federal Bureau of Investigation; IRS Criminal Investigation; the California Department of Insurance; and the United States Postal Service, Office of Inspector General.
R. Damon Rowe, Special Agent in Charge of IRS Criminal Investigation’s Los Angeles Field Office, said, “Public health insurance programs—whether a workers’ compensation program or Medicare—are not a personal pocketbook for criminals seeking to exploit government programs designed to help those who need these plans the most.”
“Taxpayers rightly expect individuals working in the healthcare industry that receive payments from taxpayer-funded programs to scrupulously follow the rules. IRS Criminal Investigation will continue to protect the integrity of public health insurance programs and ensure that doctors, pharmacists and medical service providers who profit from these illicit schemes are held accountable.”
