20 arrested in Medi-Cal fraud targeting disabled patients

Twenty people were arrested this morning in a $4.6-million Medi-Cal fraud scheme that law enforcement officials allege used unlicensed individuals to provide in-home nursing care for disabled patients.

About 75 patients, many of them children with cerebral palsy or developmental disabilities, were treated at home or at school by the unlicensed individuals who stole identities to pose as licensed nurses, according to the United States Attorney’s office.

"We believe that this is the largest single case alleging Medi-Cal fraud ever filed in the state of California," said United States Atty. Thomas O’Brien.

Those arrested this morning are among 42 defendants named in a 41-count indictment unsealed this morning. The remaining defendants are expected to turn themselves in at a later time.

From 2004 to 2007, Medicare Plus Home Health Providers, a Santa Fe Springs-based company run by Priscilla Villabroza, hired the unlicensed individuals, paying them between $8 to $12 an hour, and was reimbursed by Medi-Cal at a rate of between $20 to $35 an hour, O’Brien said. Villabroza, a registered nurse, pocketed the difference amounting to about $4.6 million, he said.

Villabroza pleaded guilty to five counts of healthcare fraud last year. She is awaiting sentencing and faces up to 50 years in prison, O’Brien said. None of the patients suffered life-threatening injuries due to the inadequate care, said Special Assistant United States Atty. Anthony Montero.

-- Raja Abdulrahim

Comments

[Guadalupe M Pankratz]

I wonder why it took the State so long to find this out.

[William Tharon Chandler]

By Tharon Chandler,
This is why it is Vital to have proper procedures and requirements for 'state licensure' with regard to vital public services such as education and health care (regarding the LA Times article and impetus for my post) . When there is much discrepency such as a conflict between 'faith-based' authority (church schools/ religious officials vs 'state credentials' and licensed teachers), as in Education, then you have a situation where one group is 'ripping-off' the customer or entitled citizen (because their teacher/ nurse is not adequately trained, according to a standard of norms and a standard of qualifications for getting success in the industry) and also a situation where an adequate and educated practitioner (one whom has paid the dues to at least have a state license) is 'crowded out' by 'fraud'.

[thecanimalshusband]

What do we tell the children when they ask what happened to all the taxpayer money?

[dakota]

track down the other 10,000 people involved in medi-cal fraud and solve the budget mess....

[Mark]

$4.6 mil next to $700 billion? Please, Villabroza merely did in a small way what the political class does with impunity - steal tax payer money.

[Santa]

Get rid of this program and the other in-home care scam that together cost taxpayers billions of dollars. Other states live without these programs somehow.

[Anti-AbuseWasteFraud]

Here is case of a twenty years old, autism nonprofit organization in Corona/Riverside has funded by Inland Regional Center through taxpayer’s money never got audit for waste and cheating on taxpayer’s money. Its autism consumers are members of “Special Olympics” and well known to the governor’s family members. Its monthly reimbursement checks from Inland Regional Center is $100,000-$200,000, but its monthly operational income only $10,000-$30,000 from sorting hangers. This nonprofits organization tries every way to make money; it also rents out the consumers to work on contracts with local governments and businesses, but it mostly pays the consumers only $0.30 to $5 an hour. It neglects and abuses consumers and one consumer was death. It hires temp workers and opens small stores at each of work stations. In the past, it also ran bingo place. However, for twenty years, this organization has claimed making no money and still depends on monthly checks of taxpayer’s money from IRC and State. It has lobby well and started receiving monthly checks from IRC right after the former Governor’s Gray David was recalled; therefore, it cannot be audited by State for waste or cheating on taxpayer’s money.

It has rent many buildings in Corona, Riverside, and Redlands, put relatives and board member on payrolls without coming to work, failed to issue 1099 to its director, mishandled fund, funds raising golfing, abused tax credit letters, tax evasion, used American Express, Sam Clubs, Costco, Price Club cards for personal expenses, used company cars and gas card for pleasure trips, enjoyed trips out of states, paid membership for golfing, irregular attendance with full paid, etc. Imagine Inland Regional Center has funded many nonprofits organizations for twenty years like the one mentioned above without auditing, State will be bankrupted very soon. For the sake of Californian Taxpayers, please try your best of ability to recoup taxpayer’s money from that nonprofits and make IRC stop that nonprofits from wasting or cheating on taxpayer’s money for personal enrichment. Here is the math for a 20 years dependency nonprofits:$200,000x12months =2.4 million x 20(years)=40.8 millions x 10(nonprofits)=408 millions. Insider.

I reported to the governor, but he did not do anything or go after them for fraud, waste, and abuse; just because they have supported him and Republican party. He cuts that nonprofit in Corona/Riverside only 3% with full protection.

[Anti-AbuseWasteFraud]

A cheated autism nonprofit in Corona/Riverside should be shut down by the governor and state lawmakers due to waste, abuse, and fraud on taxpayer's money. For instance, those disabled autism consumers or clients are already being taken care by their care takers at home so they do not need to come to a day program funding by Inland Regional Center to add more costs and burden to taxpayers. They have been working and earning only $0.10 to $5.00 an hour and they pay no income taxes while the crooked owner of a twenty years dependency nonprofit in Corona/Riverside receives funding millions of taxpayer's money to enrich himself and his associates. This twenty years dependency autism nonprofit just like a morning nursing home; duplicating costs and wasting should be shut down by the governor in order to save taxpayer's dollar as he keeps repeating that he cares for taxpayers. Governor, taxpayers want to see your action logically and fairly to IHSS and to shut down duplicating costs day program like the one I mention.Amen!

[Unbelievable!!!!]

I'm an R.N. and currently in the process of opening a Home Health Care Agency, this is the exact reason why I and other legitimate providers must go through hoops before we can get licensed. Unfortunately this was not the first, nor will it be the last that we will see of this type of fraud.

[aaron]

Make her re-pay the state for the cost of her incarceration

[FatNSassy]

Interesting that the LA Times gave more coverage to obesity brining down California's economy (which is baloney) then this deliberate fraud. They obviously wanted to scapegoat fat people and not have them look to hard at fraud. This is just the tip of the iceberg. Major corporations have their hand in the jar too.