SANTA ANA (AP) — Eleven people including doctors have been charged in Southern California in an alleged insurance-fraud scheme involving an implant surgery that purportedly helps drug addicts and alcoholics, Orange County’s top prosecutor said Wednesday.
“Orange County’s become what’s known as the ‘Rehab Riviera’ due to the proliferation of insurance fraud and the attractiveness of our communities,” District Attorney Tony Rackauckas said in announcing the case.
Five doctors, two administrators and four body brokers were charged with participating in the scheme through a business called SoberLife USA. A telephone message seeking comment was left for the owner, Thuy Rucks, 78, of Mission Viejo.
“All told, SoberLife USA is accused of billing these insurance providers over $6.8 million in health care claims for this experimental, non-FDA-approved and potentially dangerous surgery,” Rackauckas said.
All were scheduled to be arraigned Thursday on various charges including conspiring in unauthorized practice of medicine, insurance fraud, and false and fraudulent claim.
The alleged scheme involved surgeries to implant pellets of the drug Naltrexone into patients. The drug helps curb cravings for alcohol and opioids and is federally approved in pill and injectable form, but not as an implanted pellet, Rackauckas said.
The scheme involved using “body brokers” to find people in sober living homes and Alcoholics Anonymous meetings and pay them up to $1,000 to undergo the surgery, which was then billed to insurance companies, the district attorney said.
The operation involves cutting open a patient’s stomach or back and implanting a pellet. According to prosecutors, many of the patients were from out of state and developed serious side effects when they returned home.
Some patients who had the surgery were addicted to methamphetamine, not opiates, so the procedure would have no effect at all, Rackauckas said.
The district attorney said the case was the developed by the Sober Living-home Investigation and Prosecution task force, which was recently formed to focus on abuses in the region’s booming addiction services industry and community complaints.
“They often bring patients from out of state, only to max out their insurance, kick them out on the street, oftentimes contributing to the homeless issue that we are experiencing here in our community,” Rackauckas said.