The California Attorney General announced the guilty plea of a Southern California doctor, who participated in an illegal prescription scheme that defrauded the state Medi-Cal program of over $20 million.
Over the course of two years, Mohammed El-Nachef, M.D., took part in an illicit drug-prescription operation where he prescribed medically unnecessary HIV medications, anti-psychotics, and opioids to over a thousand Medi-Cal beneficiaries in the Los Angeles and Orange Counties. The medications he authorized were not kept or used by the beneficiaries, but instead diverted to the illicit market for cash.
He was charged in March 2020 with a half-dozen felony counts, including executing a scheme to defraud Medi-Cal, making a fraudulent claim for a health benefit, filing a fraudulent insurance benefit claim, conspiring in the unauthorized practice of medicine and grand theft, with sentencing enhancement allegations for aggravated white- collar crime between $100,000 to $500,000 and aggravated white-collar crime exceeding $500,000.
He was accused of helping “two convicted felons, Steve Fleming and Oscar Abrons, in a scheme to obtain expensive pharmaceuticals that were sold on the illicit market,” according to court papers filed by the state Attorney General’s Office, which was prosecuting the case.
This week El-Nachef pled guilty in the Orange County Superior Court to one count of insurance fraud and one count of aiding and abetting the unauthorized practice of medicine.
As part of his plea, El-Nachef is required to pay $2.3 million in restitution and surrender his medical license. His sentencing is set for August 1, 2023.
El-Nachef served as the prescriber at two clinics: one in Anaheim and the other in Los Angeles. El-Nachef was recruited by individuals who were involved in illegally selling the medications. These individuals solicited Medi-Cal recipients with the promise of cash payments to pose as patients, and in turn, El-Nachef agreed to prescribe these patients the medically unjustified medications. The selected drugs were among those with the highest street value.
The pharmacies billed Medi-Cal for the medications, which would ultimately end up in the hands of the individuals who recruited El-Nachef, who then sold the drugs for cash. For his part, El-Nachef received cash payments for each day he wrote prescriptions.
The California Department of Justice’s DMFEA (Division of Medical Fraud and Elder Abuse) protects Californians by investigating and prosecuting those who defraud the Medi-Cal program as well as those who commit elder abuse. These results are only made possible through the coordination and collaboration of governmental agencies, as well as the critical help from whistleblowers who report incidences of abuse or Medi-Cal fraud at oag.ca.gov/dmfea/reporting.
DMFEA receives 75% of its funding from HHS under a grant award totaling $50,522,020 for federal fiscal year 2021-2022. The remaining 25% is funded by the State of California. The federal fiscal year is defined as October 1, 2021, through September 30, 2022.
At the time of his arrest in 2020 he had stipulated to disciplinary charges filed in 2019 with the California Board of Medicine and had been placed on seven years probation.