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November 25, 2011

CAPPERS SENTENCED FOR ROLE IN MEDICAL INSURANCE FRAUD SCHEME FOR RECRUITING HEALTHY PATIENTS FOR UNNECESSARY SURGERIES IN $154 MILLION

SANTA ANA - A capper was sentenced today for her role in the largest medical fraud prosecution in the nation for recruiting over 255 healthy patients to undergo unnecessary and dangerous surgeries to fraudulently bill medical insurance companies. Pancha Keophimone, 60, pleaded guilty to a court offer Aug. 19, 2011, to 56 felony counts including conspiracy, capping, insurance fraud, grand theft, tax evasion, and sentencing enhancements for aggravated white collar crime and loss exceeding $2.5 million. Keophimone was sentenced to 12 years in state prison stayed pending completion of five years formal probation. She was ordered to serve one year and jail and will be ordered to pay restitution at a hearing on May 18, 2012.

Of the 19 defendants charged in the Unity case, 13 were indicted by a criminal grand jury on June 13, 2008. The Orange County Grand Jury examined 1,054 exhibits and heard testimony from 56 witnesses over 28 days, resulting in a 70-page indictment. The indicted defendants include an attorney, accountant, three doctors, and patient recruiters known as “cappers.”  The recruitment of patients, or “capping,” is illegal in California.

Doctor William Wilson Hampton, Jr., 56, Seal Beach, pleaded guilty May 8, 2009, to 47 felony counts including conspiracy, insurance fraud, and capping and was sentenced to 16 years in state prison. Doctor Michael Chan, 65, Cerritos, pleaded guilty Aug. 4, 2011, to the court to 40 felony counts including conspiracy to commit insurance fraud, insurance fraud, aiding and abetting capping with white collar crime sentencing enhancements. He faces a sentence ranging from probation up to 28 years in state prison at his sentencing March 9, 2012, at 9:00 a.m. in Department C-41, Central Justice Center.

Capper Sue Nanda, 43, Costa Mesa, pleaded guilty Feb. 20, 2009, to 22 felony counts including conspiracy, capping, grand theft, filing false tax returns, failing to file tax returns, and making false and fraudulent statements. She was sentenced Aug. 7, 2009, to 10 years in state prison and ordered to pay over $500,000 in restitution for personal and corporate back taxes. Capper Maria DeJesus Licea Rosales, 44, pleaded guilty Aug. 7, 2009, to 96 felony counts including conspiracy, capping, insurance fraud, grand theft, filing fraudulent tax returns, and sentencing enhancements for white collar crime and loss over $2.5 million. She was sentenced to eight years in state prison. Capper Olga Lilia Toscano, 41, pleaded guilty Aug. 11, 2009, to the court to 98 felony counts including conspiracy, capping, insurance fraud, grand theft, tax evasion, and sentencing enhancements for aggravated white collar crime and loss exceeding $2.5 million. She was sentenced to eight years in state prison.

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