Federal Prosecutors Charge 15 in $1.8 Billion Southern California Health Care Fraud Sweep

Federal agents raided addresses across Southern California before dawn Thursday. Fox News reports that 15 people, six of them medical professionals, were charged over about $1.8 billion in claims sent to government and private insurers, according to the Justice Department.

The message. Assistant Attorney General Colin McDonald of the department's National Fraud Enforcement Division said the charges include "the largest sober home fraud scheme the Department has ever prosecuted" and a scheme to perform unnecessary invasive procedures that data analytics uncovered. "If you steal health care dollars from the American taxpayer or abuse your position to harm patients, we are coming for you," he said.

The rehab case. Nathan Young, 39, and his father David Young, 71, are accused of running a $1.6 billion substance abuse scheme. Prosecutors say they brought drug users from across the country to dozens of Los Angeles rehab centers through paid "body brokers," Honey and Cody Phipps of Greenville, Texas. Once patients arrived, prosecutors say, they got no real treatment and were cycled through the facilities to keep billing insurers. Prosecutors also allege staff were told to sedate patients who tried to leave and that patients were cut off from family and blocked from leaving.

The surgery case. Dr. Harold Tabaie, 78, an Anaheim heart surgeon, and Hany Malek, 61, a Tarzana chiropractor, are charged in an alleged $135 million plan to bill Medicare for unnecessary atherectomies, procedures that use a bladed catheter to clear arterial plaque. Prosecutors say Malek posed as a medical doctor, diagnosed arterial disease patients did not have, and recommended the procedure, and that Tabaie performed it, sometimes again after earlier operations failed. Officials say several patients suffered extreme pain. Malek also faces charges over 2021 Paycheck Protection Program applications in which he allegedly invented a 25 percent revenue loss.

Other schemes. Fox lists defendants charged with stealing more than $140 million by certifying patients who were not terminally ill for hospice care, a woman accused of submitting thousands of false prescriptions for high-reimbursement generic drugs to Medi-Cal, and two doctors accused of taking kickbacks to order unneeded Medicare genetic tests.

First Assistant U.S. Attorney Bill Essayli said that when doctors "who pledged to do no harm" turn to "petty greed and criminality," it is "especially egregious."

Note for readers: charges are allegations. Every defendant named here is presumed innocent unless convicted. Details are as reported by Fox News and the Justice Department's statements quoted there.