In 2009, a multi-agency unit, including the FBI and the California Attorney General, arrested 42 people suspected of Medi-Cal fraud. These defendants were accused of defrauding Medi-Cal out of $4.6 million, making it the largest single case of Medi-Cal fraud in California’s history.
The defendants allegedly billed Medi-Cal for in-home nursing services that were provided by unlicensed individuals. Some of these individuals had no medical training whatsoever, but performed nursing services that included administering medications, adjusting ventilators, and feeding through gastronomy tubes.
Medi-Cal fraud includes billing for unnecessary services, for drugs or other supplies that were never ordered, and for paying unauthorized individuals to perform medical services. The penalties can be severe, which is why it is important that anyone accused of this type of health insurance fraud consult with a criminal defense lawyer who has expertise in this complex area of the law.