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December 21, 2012

ATTORNEY, ACCOUNTANT, AND TWO ADMINISTRATORS SENTENCED TO PRISON FOR REVENUE AND TAX CHARGES IN $154 MILLION MEDICAL INSURANCE FRAUD SCHEME

Filed under: California Defense Attorney — Tags: , , , — fayarfa @ 4:25 pm

* Additional felony fraud counts for the defendants will be tried at a later date

SANTA ANA - An attorney, accountant, and two administrators were sentenced today for violating revenue and tax codes for their roles in the largest medical fraud prosecution in the nation for recruiting over thousands of healthy patients to undergo unnecessary and dangerous surgeries to fraudulently bill medical insurance companies. This trial involved the failure to file tax returns and under-reporting income to state tax authorities. The court bifurcated the case due to its size and volume and additional fraud charges remain pending a pre-trial hearing for those counts is scheduled for Jan. 3, 2013, at 1:30 p.m. in Department C-41, Central Justice Center, Santa Ana.

Roy Chester Dickson, 64, Yorba Linda, Unity’s attorney, was sentenced to two years and eight months in state prison and $41,629 restitution. He was found guilty by a jury Nov. 26, 2012, of two felony counts of filing a false personal tax return and faces a maximum sentence of three years and eight months in state prison for these counts. Dickson faces 101 additional felony counts which include two counts of conspiracy, eight counts of capping or paying for referrals, 30 counts of grand theft, 30 counts of insurance fraud, 30 counts of making false and fraudulent claims, one count of money laundering, and white collar sentencing enhancements for taking over $2.5 million on the fraud counts.

Andrew Robert Harnen, 58, Rosemead, Unity’s accountant, was sentenced to five years and four months in state prison and $904,780 restitution. He was found guilty by a jury Nov. 26, 2012, of three felony counts of filing a false tax return and six counts of failing to file tax returns. He faces a maximum sentence of eight years and four months in state prison for these counts. Harnen faces 101 additional felony counts which include two counts of conspiracy, eight counts of capping or paying for referrals, 30 counts of grand theft, 30 counts of insurance fraud, 30 counts of making false and fraudulent claims, one count of filing a false tax return, and white collar sentencing enhancements for taking over $2.5 million on the fraud counts.

Dee Francis, 63, a Unity administrator, was sentenced to six years in state prison and $905,507 restitution. She was found guilty by a jury Nov. 26, 2012, of one felony count of filing a false tax return and six counts of failing to file tax returns. He faces a maximum sentence of seven years in state prison for these counts. Francis faces 102 additional felony counts which include two counts of conspiracy, eight counts of capping or paying for referrals, 30 counts of grand theft, 30 counts of insurance fraud, 30 counts of making false and fraudulent claims, one count of filing a false tax return, two counts of failing to file tax returns, and white collar sentencing enhancements for taking over $2.5 million on the fraud counts.

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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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October 6, 2011

Doctor Who Wrote Prescriptions for Addictive Narcotics for Cash Sentenced to Seven Years in Prison on Drug Trafficking Charges

Filed under: California Defense Attorney — Tags: , , — fayarfa @ 11:09 pm

LOS ANGELES – An Orange County doctor who maintained clinics in Downey and the Westlake District was sentenced this afternoon to 84 months in federal prison for distributing powerful and addictive painkillers to “patients” he did not examine and who simply paid cash for prescriptions.

Nazar Al Bussam, 72, of Newport Coast, was sentenced by United States District Judge S. James Otero, who remanded the doctor into custody. In addition to the prison term, Judge Otero ordered Al Bussam to pay a $125,000 fine and to forfeit more than $450,000 in profits derived from his drug trafficking activities.

Al Bussam pleaded guilty in July to 18 felony charges, including conspiracy and distributing controlled substances without a legitimate medical purpose.

A state database shows that Al Bussam, during a nearly three-year period that ended with his arrest in October 2010, was the number one prescriber of controlled substances in the entire state of California, and that he wrote about two-thirds more prescriptions than the next most prolific doctor.

In a plea agreement filed in United States District Court, Al Bussam admitted that on numerous occasions in 2009 and 2010 he distributed oxycodone, hydromorphone, hydrocodone, alprazolam, and promethazine with codeine. He admitted that he wrote prescriptions for these narcotics outside of the usual course of professional practice and without a legitimate medical purpose. Al Bussam sold the prescriptions to individuals for cash, and the individuals later filled the prescriptions at pharmacies.

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September 29, 2011

SAN FERNANDO VALLEY DOCTOR CONVICTED OF SELLING BOGUS CANCER CURE TO CHRISTIANS ACROSS THE NATION

Filed under: California Defense Attorney — Tags: , — fayarfa @ 9:22 pm

LOS ANGELES – The owner of a Mission Hills medical clinic has been found guilty of federal charges for selling a bogus cancer cure to dozens of patients across the country.

Christine Daniel, 57, of Los Angeles, who operated a clinic under names such as the Sonrise Wellness Center, was convicted yesterday afternoon in United States District Court. A federal jury deliberated for two days before finding Daniel guilty of 11 counts: four counts of mail and wire fraud, six counts of tax evasion with regard to her personal and corporate income tax filings, and one count of witness tampering.

Daniel, a medical doctor and a prominent evangelical Christian minister and medical doctor, fraudulently marketed and sold a medical treatment that she and her employees claimed could cure many diseases and conditions, including cancer, multiple sclerosis, stroke, Alzheimer’s Disease, Parkinson’s Disease, diabetes, and hepatitis. Daniel claimed that the bogus cancer cure had an effective success rate of between 60 percent and 100 percent for Stage IV metastatic or terminal cancers.

The evidence presented during the trial showed that Daniel used her status as a minister to create a bond of trust with members of the Evangelical Christian community, an affinity that provided her with a market to sell her bogus treatments. Daniel promoted the product under a variety of names – including “C-Extract,” “the natural treatment” and “the herbal treatment” – through a program televised on the Trinity Broadcasting Network.

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July 22, 2011

DOCTOR PLEADS GUILTY TO 18 DRUG TRAFFICKING CHARGES FOR DISPENSING NARCOTICS WITHOUT EXAMINING PATIENTS

Filed under: Federal Crimes Defense Attorney — Tags: , , — fayarfa @ 10:46 pm

LOS ANGELES – A medical doctor who maintained clinics in Downey and the Westlake District pleaded guilty this afternoon to federal narcotics charges for distributing powerful and addictive painkillers to “patients” he did not examine and who simply paid cash for prescriptions.

Nazar Al Bussam, 72, of Newport Coast, pleaded guilty to 18 felony charges, including conspiracy and distributing controlled substances without a legitimate medical purpose.

Al Bussam pleaded guilty before United States District Judge S. James Otero, who scheduled a sentencing hearing for October 5. As a result of today’s guilty pleas, Al Bussam faces a statutory maximum sentence of 230 years in federal prison, a lifetime period of supervised release, and a fine of up to $11.5 million.

In a plea agreement filed last night in United States District Court, Al Bussam admitted that on numerous occasions in 2009 and 2010 he distributed oxycodone, hydromorphone, hydrocodone, alprazolam, and promethazine with codeine. He admitted that he wrote prescriptions for these narcotics that were outside of the usual course of professional practice and without a legitimate medical purpose. Al Bussam sold the prescriptions to individuals for cash, and the individuals later filled the prescriptions at pharmacies.

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June 16, 2011

RADIOLOGIST- NEUROLOGIST- AND TWO CO-DEFENDANTS INDICTED IN $17 MILLION WORKERS COMPENSATION INSURANCE OVERBILLING SCHEME

Filed under: California Defense Attorney — Tags: , , — fayarfa @ 5:10 pm

*Grand jury transcripts revealed for the first time

SANTA ANA - The Orange County District Attorney’s Office (OCDA) and California Department of Insurance (CDI) announced today the facts surrounding the indictment of a radiologist, a neurologist, and two co-defendants for a $17 million workers’ compensation insurance overbilling scheme. The indictments against the four defendants were issued May 11, 2011, and the grand jury transcripts were unsealed today, June 13, 2011.

We need to end these types of medical fraud mills - STAT. Let’s end unethical doctors, unscrupulous dealings, and patients being treated like walking ATMs,” stated District Attorney Tony Rackauckas. “We hope before people engage in these types of schemes, they ask themselves if this is worth 800 years in prison?”

“The magnitude of the fraud committed by these co-conspirators is reprehensible,” said Insurance Commissioner Dave Jones. “When medical providers conspire to defraud the California workers’ compensation insurance system, everybody loses, including the injured workers and the businesses that employ them.”

This case was investigated by CDI and the OCDA. Deputy District Attorney Shaddi Kamiabipour of the Workers’ Compensation Fraud Unit is prosecuting this case.

Defendants
Dr. Sim Carlisle Hoffman, 59, Newport Beach, is a radiologist and owner of Advanced Professional Imaging (API), Advanced Management Services (AMS), and Better Sleeping Medical Center (BSMC) in Buena Park. He is charged with 592 felony counts of insurance fraud for BSMC, 291 felony counts of insurance fraud for API, and one felony count of aiding and abetting the unauthorized practice of medicine. If convicted, he faces a sentence ranging from two years up to 892 years and eight months in state prison. Hoffman is out of custody on $1.5 million bail. In 2001, Hoffman was disciplined by the Medical Board of California (Board) for excessive billing and subjecting a patient to radiology procedures that were not medically necessary.

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