The Orange County District Attorney has filed charges against 26 doctors, pharmacists and business owners in a crackdown on an alleged $40 million workers’ compensation fraud that involved overbilling for unnecessary compound creams and urine tests. The defendants billed workers’ compensation insurers for $40 million and collected $23 million, according to the California Department of Insurance, which led the investigation.
The Kings are accused of pocketing more than $18.5 million from at least 27 insurance companies. Tanya Moreland King, 37, and her husband Christopher King, 38, both of Beverly Hills, own medical billing and medical management companies Monarch Medical Group, Inc., King Medical Management, Inc. and One Source Laboratoires, Inc. The defendants are accused of masterminding a complex insurance fraud scheme of recruiting doctors and pharmacists to prescribe unnecessary treatment for workers’ compensation insurance patients.
Irvine pharmacists Charles Bonner, RPh., 56, and Mervyn Miller, RPh., 66, both owners of Steven’s Pharmacy, are accused of conspiring with Christopher and Tanya King by selling more than $1 million in compound creams that were not FDA approved nor have known medical benefits.
The Kings are accused of making oral and written agreements with doctors across the state paying them each time they prescribed a compound cream or oral medication or ordered a urine drug test. The doctors or the companies connected to them are accused of labeling the payments “marketing expenses” in an attempt to conceal the kickbacks. The Kings are accused of rewarding doctors who provided higher volume by paying for office technicians.
Prosecutors also accuse the Kings of working with pharmacist and co-defendant Charles Bonner, owner of Stevens Pharmacy in Costa Mesa, to manufacture a variety of creams with unknown effects from Steven’s Pharmacy that were not FDA approved. The Kings purchased the creams for between $15 and $40 per tube. These products were then billed to patients’ workers’ compensation insurance carriers for between $250 and $700 dollars per tube. Tanya King is accused of recruiting physicians to participate in this scam by paying a flat $50 rate or a share in the profits.
They allegedly purchased repackaged oral pain medications from two companies: NuCare Pharmaceuticals in Orange and A-S Medication Solutions in Costa Mesa. Using their company Monarch Medical Group as a cover, the Kings are accused of repackaging meds sent directly to the physicians involved in the scam. As the doctors dispensed the medication, the bar code on the packaging was scanned, notifying the Kings. The Kings are accused of billing workers’ compensation insurance carriers without disclosing the wholesale cost or the fact they had purchased the medication on behalf of the physicians who ultimately prescribed it. Once the Kings received the payment, they are accused of splitting the profits with the prescribing physician based upon a pre-arranged agreement.
The Kings are also accused of providing technical staff to participating physician’s offices through their company One Source Labs. The doctors are accused of ordering unnecessary urine tests, under the guise of verifying patients on workers’ compensation insurance were taking their medications as prescribed. The urine samples were then tested by One Source Lab technicians or the doctors’ staff and billed to the insurance company on behalf of the physicians by King Medical Management. The results were then referred to Pacific Toxicology Laboratory for additional testing, regardless of results. Through their company One Source Labs, the Kings are accused of paying Pacific Toxicology a flat rate of $60 per test and billing the insurance carriers hundreds of dollars per patient.
The following defendants are charged for their part in the fraudulent schemes. The list below may provide an opportunity to determine if there is any teeth in new law (SB 1160) that theoretically bans providers who are charged with medical fraud from collecting liens until the case is concluded.
– Tanya King, 37, Beverly Hills
– Christopher King, 38, Beverly Hills
– Charles Bonner, RPh., 56, Irvine
– Mervyn Miller, RPh., 66, Irvine
– Rafael Chavez, P.A., 53, Apple Valley
– Dr. Jerome Robson, 68, Modesto
– Dr. Eric Schmidt, 63, Santa Rosa
– Dr. Chris Chen, 55, Pleasanton
– Dr. Duke Ahn, 49, Los Alamitos
– Dr. Robert E. Caton, 65, Modesto
– Dr. Ismael Silva Jr., 63, Newport Coast
– Dr. Ismael Geli Silva, 38, Huntington Beach
– Dr. Paul A. Stanton, 54, Victorville
– Dr. William Pistel, 53, Modesto
– Dr. Kevin Park, 49, Buena Park
– Dr. Kourosh Shamlou, 49, Newport Coast
– Dr. Mannie Joel, 67, Pleasanton
– Dr. Parvez Fatteh, 46, Pleasanton
– Dr. Robert Fenton, 68, Ranchos Palos Verdes
– Dr. Michael Henry, 61, Granite Bay
– Dr. Howard Oliver, 70, Long Beach
– Dr. Eduardo T. Lin I, 55, Pleasanton
– Dr. Paul Kaplan, 76, Folsom
– Dr. Mohamed Ibrahim, 40, Danville
– Dr. Jonathan Cohen, 57, Modesto
– Dr. John Casey Jr., 65, Modesto