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Eleven people, including doctors, have been charged in Southern California with a so-called insurance fraud scheme involving implant surgery to help addicts and alcoholics, the Orange County prosecutor said on Wednesday.
"Orange County has become what we call the" Riviera Rehabilitation "because of the proliferation of insurance fraud and the attractiveness of our communities," said prosecutor Tony Rackauckas.
Five doctors, two administrators and four staff brokers were instructed to participate in the program through a company called SoberLife USA. A phone message asking for a comment was left to the owner, Thuy Rucks, 78, of Mission Viejo.
"In total, SoberLife USA is accused of having charged these insurance companies more than $ 6.8 million in medical care for this experimental, non-FDA-approved and potentially dangerous surgery," Rackauckas said.
All were to be brought to justice on Thursday on various charges, including conspiracy in the unauthorized practice of medicine, insurance fraud and fraudulent demand.
The presumed schema involved surgeries to implant granules of the drug Naltrexone into the patients. The drug helps fight against alcohol cravings and opioids and is approved by the federal government in tablet form and injectable form, but not in the form of implanted pellets, said Rackauckas.
The project involved the use of "body brokers" to find people in sober homes and meetings of Alcoholics Anonymous and pay them up to $ 1,000 to undergo the operation, which then went on to was billed to the insurance companies.
The operation involves cutting the belly or back of a patient and implanting a lozenge. According to prosecutors, many patients were out of state and had serious side effects when they returned home.
Some patients who underwent surgery were dependent on methamphetamine and not on opiates, so the procedure would have no effect, Rackauckas said.
The District Attorney stated that the case had been developed by the Sober Living-Home Investigation and Prosecution Working Group, recently created to focus on abuses in the burgeoning sector of addiction services and complaints of drug abuse. the community.
"They often bring patients from outside the state, only to maximize their insurance, kick them out on the street, often contributing to the homelessness problem we encounter here in our community," he said. Rackauckas.
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