Fraud Case Alleges Hundreds of Surgeries By Non-Doctor

An orthopedic surgeon, his lawyer, another doctor, and 12 other defendants (15 in total) have been charged in a California health-care fraud conspiracy in Los Angeles. This past Thursday, Los Angeles county prosecutors handed down indictments for Dr. Munir Uwaydah and the associates who helped cover his illicit activity. The conspiracy ring is alleged to have prescribed unnecessary expensive medications, billed two-minute doctor’s appointments as hour-long examinations, and doctored MRI results and medical records to justify unnecessary operations.  It is also alleged that Dr. Uwaydah allowed his physician’s assistant, Peter Nelson, to perform surgeries at an Orange County hospital in 2005. Dr. Uwaydah’s medical license was revoked two years ago after several earlier allegations.

The conspiracy ring is estimated to have cheated insurance companies out of $150 million. It is described as one of the largest health-care schemes in state history. Uwaydah and Nelson are charged with 21 counts of aggravated mayhem — each for a different patient. The District Attorney stated that this is a vast underestimation of the hundreds of procedures that Nelson performed. Nelson is being held on a $21 million bail. The office manager, Kelly Soo Park, 49, is also being held on $18.5 million bail in the fraud case for her involvement in hiding Uwaydah’s money from investigators.  

Health Care Fraud in California

Although health care fraud can be categorized as a white-collar crime, it is still a crime associated with steep penalties. Health care fraud is also commonly called medical insurance billing fraud, health insurance fraud, HMO fraud, Medicare fraud, or Medi-Cal Fraud. It may be committed by the patient or medical provider. Examples of health care fraud include:

  • Billing for medical services that were never actually received;
  • Billing for more expensive services than what the patient received; or
  • Submitting duplicate claims.

Under California Penal Code 550(a), if the alleged fraud is worth no more than $950 in total, then the offense is a misdemeanor punishable by six months and a $1,000 fine. If the fraud is worth more than $950, then the offense is a wobbler—meaning it may be prosecuted as either a felony or misdemeanor. Once charged as a felony, you may face a fine of $50,000 (or double the amount you defrauded) and up to five years imprisonment.  

Defenses to charges of California health care fraud include mistake of fact and lack of intent to defraud.

San Diego Fraud Lawyer

The Law Offices of David M. Boertje have handled all types of misdemeanor and felony criminal cases in San Diego County including extortion, identity theft, medical and insurance fraud, credit card fraud, and other related crimes. We are licensed to practice in federal court and state court and can represent you in your criminal defense case during the entire process. If you have been charged a fraud-related crime, do not wait to contact our office today. This is a serious charge. Do not try to fight it alone! Our consultations are free and confidential.