Four Modesto, Calif.-based Stanislaus Orthopaedic and Sports Medicine physicians are awaiting pretrial hearings for allegedly participating in a $40 million fraudulent billing and kickback scheme, The Modesto Bee reports.
Here's what you should know:
1. John Casey, MD, Jonathan Cohen, MD, Mohamed Ibrahim, MD, and William Pistel, DO, were arraigned in April 2017 on felony counts of conspiring to commit medical insurance fraud, false and fraudulent claims and insurance fraud. The physicians reportedly received a combined $248,000 in kickbacks.
2. They were among 26 physicians, pharmacists and business owners accused of participating in a scheme to maximize earnings from worker's compensation patients. The alleged scheme was led by Tanya Moreland King and Christopher King, who owned Irvine, Calif.-based Monarch Medical Group, Beverly Hills, Calif.-based King Medical Management and Beverly Hills-based One Source Laboratories.
3. From 2011 to 2015, the defendants allegedly billed $40 million to 27 insurance carriers, including charges for unnecessary creams, urine tests and treatments. Those participating in the conspiracy received more than $23 million in kickbacks, authorities said.
4. Another physician charged with participating in the scheme, orthopedic surgeon Robert Caton, MD, accepted a deal with the prosecution and pleaded guilty to a misdemeanor charge of false and fraudulent claims and taking kickbacks. The other physicians charged could be offered a similar plea deal.
5. The Stanislaus Orthopaedic and Sports Medicine physicians' pretrial hearing is scheduled for Jan. 18.
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