A widespread probe of Medi-Cal abuses stretched to the dentistry program Wednesday with the arrest in Los Angeles of three women and one man accused of operating a $1-million fraud ring that used San Joaquin Valley farm workers and other low-income people to make phony claims.
Shortly after the arrests, law enforcement officials raided the Pico Cosmetic Dental clinic in South Gate, which they said is one of the facilities suspected of being involved in the operation.
Law enforcement officers said the arrests and the raid were the first in an ongoing investigation of dental clinics throughout the Los Angeles area. The clinics used recruiters called "cappers" to comb farm worker and other low-income communities for poor laborers who qualified for Medi-Cal, the state's medical poverty program, according to the officers.
"[This] marks the beginning of a concerted effort by the attorney general and the Los Angeles County Health Authority to control the rapid proliferation of dentists fraudulently billing the Medi-Cal program for unnecessary and oftentimes unperformed dental work," said Collin Wong, director of the state attorney general's Bureau of Medi-Cal Fraud and Elder Abuse.
The arrests show that the state believes that massive, organized fraud has spread beyond the few sectors of Medi-Cal that have been the focus of an FBI investigation, and into unrelated areas such as Denti-Cal, which provides dental services to the poor.
The newest fraud revelations follow earlier discoveries by the FBI of false billings to Medi-Cal by medical supply businesses, laboratories and pharmacies. The FBI estimates that fraud in the Medi-Cal program exceeds $1 billion.
In the latest scam, law enforcement officials said, farm workers were offered a fee to travel to Los Angeles and visit certain clinics for dental services. Those who accepted were loaded into vans and transported in groups.
The clinics, law enforcement officials said, often performed services, particularly fillings, that were not needed and then billed Medi-Cal for them. In other instances, they said, the clinics billed Medi-Cal for expensive procedures that were never performed.
"It's a vast network of people and it seems to be occurring all over Los Angeles," said Don Ashton, the environmental health specialist on the Health Authority's law enforcement task force. "You have cappers that drive for all these different doctors. They go into low-income areas and say, 'We'll give you $20 if you'll come in and let us do a checkup and any dental work for free.' "
