Seven from O.C. arrested in nationwide health fraud sweep

A Laguna Beach psychiatrist and six other Orange County residents have been charged with participating in Southern California health fraud schemes that bilked government insurance programs of more than $125 million, prosecutors said Wednesday.
In all, 22 defendants face federal charges in Santa Ana and Los Angeles as part of a nationwide sweep involving 301 people accused of falsely billing $900 million, the U.S. attorney’s office said. Authorities described the takedown as the largest in U.S. history, both in the number of those arrested and the financial scope of the fraud.
The Orange County defendants were accused of crimes that involved billing Medicare for occupational therapy that was never provided, submitting false patient reports for state workers’ compensation and paying kickbacks for expensive prescriptions that were billed to TRICARE, the military’s insurance plan.
“Those who commit fraud targeting health care funding get rich on the backs of American taxpayers who watch their premiums go up,” Deirdre Fike, assistant director in charge of the FBI’s Los Angeles field office, said in a statement.
Most of the Southern California cases stemmed from a compounding pharmacy scheme targeting TRICARE. Compounding pharmacies formulate personalized medicines, but prosecutors said those involved prepared formulas aimed at the highest possible profit, not maximum effectiveness.
Doctors allegedly were paid kickbacks for prescribing medications with reimbursements of up to $15,000. Patients often didn’t want the medicine or never had met the prescribing doctor. In other cases, marketers provided pharmacies with illegally obtained information on beneficiaries and then prescriptions were mailed to them each month.
TRICARE paid hundreds of millions of dollars for creams for minor pain, scars, erectile dysfunction or general wellness, prosecutors said.
Those from Orange County charged and arrested Tuesday in the pharmacy cases are:
• John Garbino, 46, of Dana Point, charged with receiving illegal kickbacks after his marketing business referred prescriptions to compounding pharmacies who then paid him as much as 65 percent of the reimbursement. He will be arraigned July 18.
• Randy Jett, 70, of Lake Forest, charged with offering to pay a doctor for writing prescriptions.
• John Kosolcharoen, 44, of Santa Ana, charged with paying $100,000 in kickbacks for his work with Irvine Wellness Pharmacy, which received more than $11 million in 2015 from TRICARE. His arraignment was set for July 18.
Other cases involved:
• Dr. Samuel Albert, 81, of Laguna Beach, a psychiatrist who operated an office in Fountain Valley, charged on Tuesday with conspiring to commit health care fraud. He has signed a plea agreement stemming from allegations that he billed workers’ comp for $4.2 million between 2008 and 2014 from fraudulent patient reports based on templates with copied and pasted information.
According to state medical board records, Albert has been disciplined twice, most recently in 2005 for gross negligence after charging a workers’ comp patient for services already covered by her insurer.
• Simon Hong, 54, of Brea and his wife, Grace Hong, 50, who were arrested Monday and pleaded not guilty after being charged with billing Medicare for occupational therapy that was never provided at a facility they owned, JH Physical Therapy in Walnut. Instead, patients received massage and acupuncture, which are not covered by Medicare. Medicare paid the clinic more than $3.7 million.
• Mark Holzer, 49, of Huntington Beach, charged earlier this month with making a fraudulent claim that he was disabled and unable to perform his job at the U.S. Postal Service. He has signed a plea agreement and is awaiting a hearing.