Dr. Robert Caton, a Modesto orthopedic surgeon accepted an agreement with the prosecution in September, pleading guilty to a misdemeanor charge of false and fraudulent claims and accepting kickbacks. More than 20 felony counts and enhancements in the original criminal complaint were dismissed.
Caton was sentenced to three years probation and agreed to pay $175,270 in restitution to the scammed insurance companies. He also agreed to pay $18,000 to a victim’s witness emergency fund.
“He accepted responsibility and paid back the money he made from the arrangement with Mr. King,” said Shaddi Kamiabipour, a senior prosecutor for the Orange County district attorney. She said the penalty was not unusual for someone whose involvement was less than others.
He was the first of 26 doctors, pharmacists and business owners to accept a plea deal following the massive indictments.
A similar plea deal could be offered to the other local physicians because there’s no evidence their patients were physically harmed, an Orange County prosecutor said.
Five local physicians charged with participating in a $40 million fraudulent billing and kickback scheme are set for pretrial hearings in December and January.
A total of six doctors who practice in Modesto were arraigned in April 2017 on felony counts of conspiring to commit medical insurance fraud, false and fraudulent claims and insurance fraud, following a multiagency investigation led by the California Department of Insurance.
Authorities said they were among 26 doctors, pharmacists and business owners in California charged with participating in the alleged conspiracy to maximize profits from workers compensation patients. Charged with masterminding the scheme are Tanya Moreland King and her husband Christopher King of Beverly Hills, who owned Monarch Medical Group, King Medical Management and One Source Laboratories in Southern California.
Irvine pharmacists Charles Bonner, RPh., 56, and Mervyn Miller, RPh., 66, both owners of Steven’s Pharmacy, were 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 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.
Doctors John Casey, Jonathan Cohen, Mohamed Ibrahim and William Pistel of Stanislaus Orthopaedic and Sports Medicine on East Orangeburg Avenue are set for a pretrial hearing Jan. 18 in Orange County Superior Court. Another Modesto physician, Jerome Robson, has a pretrial court date Dec. 3.