Deputy District Attorney Shaddi Kamiabipour Takes On A New Workers' Compensation Fraud Case In Orange County. Tanya And Christopher King, With Three Medical Companies, Allegedly Billed Workers' Comp Payers Over $40 Million Fraudulently And Illegally.
By Lonce LaMon - April 21, 2017
Deputy District Attorney Shaddi Kamiabipour, of the Orange County District Attorney’s office, has just taken on yet another significant workers’ compensation fraud case as the lead prosecutor.
This new case now centers around a married business couple, the Kings—Tanya Moreland King and Christopher King—who are from Beverly Hills, California. They are attractive and only in their late thirties.
The Kings ran the medical businesses of Monarch Medical Group, Inc., King Medical Management, Inc., and One Source Laboratories which the California Insurance Commissioner and the Orange County District Attorney have shut down after approximately 40 million dollars in illegal and fraudulent billings having been presented to workers’ compensation payers between 2011 and 2015. Of that $40 million billed, approximately $23.2 million has been paid to the defendants.
Tony Rackauckas, Orange County District Attorney, and Dave Jones, California Insurance Commissioner, held a partnership News Conference yesterday morning in the OCDA’s office library at 401 West Civic Center Drive in Santa Ana. Together they described the Kings as being the masterminds of three scams:
1. The Snake Oil Scam
2. The Medical Kickback Scam
3. The Bogus Urine Test
California Insurance Commissioner Dave Jones talks to reporters at the Press Conference held in the OCDA library in Santa Ana yesterday morning. photo by Lonce LaMon, all rights reserved
The “snake oil scam” is in the family of the long, worn-out, illegal manufacture of compound transdermal creams activity which distributes medication creams to workers’ compensation patients. Why this game is still slipping by the workers’ compensation payers is the right question. Mass production in manufacturing compound medications, or any medications for that matter, is illegal without FDA approval; and in this case the mass production of a variety of creams with unknown effects from Steven’s Pharmacy in Costa Mesa had no FDA approval.
Transdermal creams individually produced for individual patients without FDA approval are legal when they are created on an individual patient by patient basis. But this is not what occurred here.
The creams were mass produced by pharmacist Charles Bonner, of Irvine, who is the owner of Steven’s Pharmacy in Costa Mesa without FDA approval. His co-owner, Mervyn Miller, was also a participant and is now a defendant in this case along with Bonner. These two pharmacy owners allegedly conspired together with the Kings to sell more than $1 million in allegedly bogus compound creams which have not been determined to have any medical benefits, so far.
DDA Shaddi Kamiabipour, center, standing in 3rd position classical ballet style, attended the News Conference yesterday at the OCDA's office library in Santa Ana. Shaddi will take on 19 new filed complaints in prosecuting 26 defendants, which consist of business owners Tanya and Christopher King, two pharmacists, 21 medical doctors and a physician's assistant. photo by Lonce LaMon, all rights reserved
The Kings purchased the creams for between $15 and $40 per tube. These products were then billed to patients’ workers’ compensation payers for between $250 and $700 dollars per tube. Tanya King is accused of recruiting physicians to participate in this scam by paying either a flat $50 rate or a share in the profits.
In the “medical kickback” scam, the Kings are accused of purchasing repackaged oral pain medications from two companies: NuCare Pharmaceuticals in Orange and AS Medication Solutions in Costa Mesa. Using Monarch Medical Group, the Kings are accused of repackaging these medications sent directly to the physicians involved in the scam. When the doctors dispensed the medication, the bar code on the packaging when scanned notified the Kings. Then the Kings allegedly billed the workers’ compensation payers without disclosing the wholesale cost or the fact they had purchased the medication on behalf of the physicians who ultimately prescribed it. When the Kings received the payment, they are accused of splitting the profits with the prescribing physician based upon a pre-arranged agreement.
In the bogus urine test scam, the Kings are accused of providing technical staff to participating physicians’ offices through their company One Source Labs. The doctors are accused of ordering unnecessary urine tests, under the guise of verifying workers’ compensation patients were taking their medications as prescribed. The urine samples were tested by One Source Labs technicians or the doctors’ staff and billed to the workers’ compensation payers on behalf of the physicians by King Medical Management. The results were then referred to Pacific Toxicology Laboratory for additional testing no matter what the 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 workers’ compensation payers hundreds of dollars per patient.
Shaddi Kamiabipour, center facing front, listens to reporters. photo by Lonce LaMon, all rights reserved
District Attorney Tony Rackauckas repeated twice during his speech to the news media yesterday that the majority of doctors are upstanding and ethical professionals.
Tony Rackauckas: In order for the system to survive, we have to deal with a few dishonest players. The vast majority of medical providers are upstanding. The vast majority of physicians are ethical people.
It felt as if Tony wants his constituency to know that he thinks most medical professionals are honest and trustworthy people. He thinks it’s the slim minority who are the criminals.
Insurance Commissioner Dave Jones put out a message to physicians.
Dave Jones: If you’re putting patients at risk, we’re going to come after you.
His message expressed that when doctors put profits and kick-backs ahead of the patients’ needs, a crime is being committed.
Orange County District Attorney Tony Rackauckas from the podium yesterday looks at the list of physicians involved in the workers' compensation fraud scam perpetrated by the Kings during the years 2011 to 2015. photo by Lonce LaMon, all rights reserved
Dave Jones: These are very egregious crimes. When the health of the individual is put at risk because the physician is getting a kick back--and that kick back is determining whether they’re going to prescribe medications, whether they’re going to do a test, whether they’re going to provide a particular treatment-- instead of what’s in the interest of the patient, that undermines the very system of medical care.
These physicians betrayed the trust the patients put in them. They violated their oath, and they violated the law.
The 21 doctors and one physician’s assistant who are co-defendants in this case are:
· 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. Eduardo T. Lin I, 55, Pleasanton
· Dr. Ismael Silva Jr., 63, Newport Coast
· Dr. Ismail Geli Silva, 38, Huntington Beach
· Dr. Paul A. Stanton, 54, Victorville
· Dr. John Casey Jr., 65, Modesto
· Dr. Jonathan Cohen, 57, Modesto
· Dr. Mohamed Ibrahim, 40, Danville
· Dr. William Pistel, 53, Modesto
· Dr. Kevin Park, 49, Buena Park
· Dr. Kourosh Shamiou, 49, Newport Coast
· Dr. Mannie Joel, 67, Pleasanton
· Dr. Parvez Fatteh, 46, Pleasanton
· Dr. Robert Fenton, 68, Rancho Palos Verdes
· Dr. Michael Henry, 61, Granite Bay
· Dr. Howard Oliver, 70, Long Beach
· Rafael Chavez, P.A., 53, Apple Valley
· Dr. Paul Kaplan, 76, Folsom
The charges consist of Insurance Fraud, Conspiracy to Commit Medical Insurance Fraud, False and Fraudulent Claims, Rebates for Patient Referrals, Referral of Clients for Compensation. These charges have been meted out in 19 separate complaints.
The two pharmacists could serve up to 28 years in prison. The 21 physicians and one physician assistant could serve up to 25 years in prison. Tanya King could serve up to a maximum sentence of 117 years in prison.
Video: $40 Million Workers' Compensation Insurance Fraud Kickback Scheme-- News Conference, given by the Orange County District Attorney and the California Insurance Commissioner on April 20th 2017 (Charging Documents found on this same page.)
lonce@adjustercom.com; Lonce LaMon, journalist, copyright adjustercom and Lonce LaMon, all rights reserved
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