OC district lawyer costs surgeon, girlfriend with sober residing dwelling insurance coverage fraud – Orange County Register

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OC district attorney charges surgeon, girlfriend with sober living home insurance fraud – Orange County Register

A Beverly Hills surgeon and his girlfriend have pleaded not guilty to stealing nearly $ 52 million in a sophisticated insurance fraud program that has hired brokers to take patients to sober Southern California homes for medically unnecessary surgery, medical testing, and others medical procedures to pay, officials said Friday, July 3.

Dr. Randy Rosen did not plead guilty on Thursday to having committed 88 crimes in two separate cases, while Rosen's girlfriend – 41-year-old Liza Visamanos from Los Angeles – did not plead guilty to the system in two separate cases.

The couple was arrested on Tuesday. The deposit was originally set at $ 52 million. On Thursday, a commissioner reduced the bail of roses to $ 15 million in one case and to $ 1 million in the other. Visamanos' bail was reduced to $ 3 million in one case and to $ 100,000 in the second. Both defendants are GPS-monitored by the Orange County Prosecutor's Office.

Rosen's lawyer Harland Braun mocked the original $ 52 million bail on Wednesday. "How can you have a $ 52 million bail if murder is a $ 1 million bail?" Braun asked.

Vismanos' lawyer, Paul Meyer, declined to comment.

Multi-million dollar fraud program

According to an application to increase the couple's bail, investigators said Rosen was "charged with being in a multi-million dollar fraud program and is currently on bail in this case."

Braun said Rosen had been involved in another Orange County Superior Court case in which a judge found that an investigator had violated law and client law, and the case is pending.

The couple reportedly recruited and hired numerous body brokers to find and pay for patients for medically unnecessary naltrexone implant surgery and cortisone shots. According to the prosecutor, several insurance companies have been charged for these unnecessary procedures and have never been informed that patients have been traded and paid for.

Insurance companies were allegedly fraudulently charged approximately $ 600 million and paid approximately $ 50 million.

Rosen is said not only to subject the patient to medically unnecessary interventions, but also to have unnecessary drug tests carried out, which he sent for testing to the Lotus Laboratories owned by his girlfriend. California law prohibits such referrals if the doctor or immediate family has a financial interest in the person or organization receiving the referral. Lotus Laboratories is believed to have fraudulently billed more than $ 3 million to at least 22 different insurers.

Four other people were charged with the case. Robert Mellon, 52, from San Diego; Thomas Douglas, 29 from Playa del Rey; Shea Simmons, 28, from Jeanerette, Louisiana; and Patrick Connolly, 28, of Los Angeles, are also charged with crime for participating in the program.

"Twisted Plot" for lining bags

"Vulnerable, sober patients who tried desperately to fight their addiction were treated like human guinea pigs just to make money," said Todd Spitzer, Orange County District Attorney. "I refuse to allow these body brokers to exploit and turn people around as part of a sick and twisted conspiracy to fill their own pockets. This prosecution is a testament to the hard work of our prosecutors and our investigative office to bring these real Frankensteins to account. "

Rosen was involved in a civil lawsuit involving a healthcare fraud program in a Long Beach hospital that was resolved in 2017.

He is charged with crimes ranging from money laundering to submitting false documents to conspiracies to commit illegal patient transfers and withhold key facts about insurance claims. If he is convicted in every way, he faces a maximum of 84 years and eight months in prison, the prosecutor said.

Vismanos is charged with a similar series of crimes and faces a maximum of 36 years and four months in prison if convicted.

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