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FBI, insurers target fraudulent surgeries; Clinics paying people for unnecessary operations
By ROBERTO CENICEROS
LOS ANGELES-Surgical centers in Southern California are defrauding employer health plans by recruiting thousands of employees to undergo unnecessary operations that are then billed to the health plans, the Federal Bureau of Investigation says.
Health insurers as well as large self-insured employers and their third-party administrators have fallen victim to the scams, according to Daniel Martino, supervisory special agent for the FBI's health care fraud unit in Los Angeles. Losses so far total about $500 million, according to insurers and the FBI.
Under the scams, individuals are told that, depending on the procedure ...
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