California Officials Bust $17 Million Insurance Scam
June 14th, 11A radiologist, a neurologist and two other people are accused in a $17 million workers’ compensation insurance over-billing scheme, according to Insurance Journal. The Orange County, California District Attorney’s Office and the California Department of Insurance released details of the case this week.
According to officials Dr. Sim Carlisle Hoffman of Newport Beach, a radiologist and owner of several medical practices, is charged with 592 felony counts of insurance fraud for one of his businesses, and 291 felony counts of insurance fraud for another. That means if he’s convicted he could face a sentence ranging from two years to more than 892 years in state prison. He’s currently been released on bail. Insurance Journal reports that Beverly Jane Mitchell, who served as the administrator in charge of insurance billing at Hoffman’s businesses, faces the same charges and sentence.
Another doctor, neurologist Thomas Michael Heric, worked with Hoffman and faces 296 counts of insurance fraud. He could face any where from two years to more than 315 years in state prison. Finally a fourth man, Louis Umberto Santillan, worked for Hoffman in his billing collections area and faces 141 felony counts of insurance fraud. All four will be arraigned on June 22.
Authorities say Hoffman billed certain tests as many as 20 times per patient, but he never completed the test. Insurance billings that should have cost about $2,000 were inflated to $10,000. Hoffman is accused of fraudulently billing seven different insurance companies for millions of dollars in fake claims.
Tags: bail, scheme, billing, Law Crime, compensation, charge
