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Insurance Fraud

February 9, 2013 | By Richard Winton and Hailey Branson-Potts, Los Angeles Times
A member of the Moreno Valley Unified School District board was convicted on nearly two dozen charges including pimping and pandering for running a prostitution ring from his home. Mike Rios, 42, was immediately taken into custody after the trial in Riverside, according to the Riverside County district attorney's office. Young women testified that Rios ran a prostitution ring in 2011 and 2012 and solicited at least one young woman on the street using his school board business card.
October 5, 2012 | David Lazarus
You already knew that our healthcare system is screwy. But you probably didn't know that at least some pharmacists at CVS, the nation's second-largest drugstore chain, were refilling prescriptions and submitting claims to insurers without patients' approval. The bizarre, possibly illegal practice was spelled out in confidential emails sent this year by a CVS pharmacy supervisor to dozens of pharmacists under his control. The emails make clear that an internal quota existed for prescription refills, with at least 30% of calls to patients about their medications expected to result in return business.
August 25, 2012 | By Tiffany Hsu, Los Angeles Times
The car stolen most often in the U.S. last year - for the fourth year in a row - was the 1994 Honda Accord, according to the annual Hot Wheels report from the National Insurance Crime Bureau. Next, thieves liked to go for the 1998 Honda Civic, according to the report from the nonprofit group that focuses on theft and insurance fraud prevention. Honda vehicles have been the two most popular autos for thieves since 2005. The third-most-stolen car was a full-size 2006 Ford pickup.
August 15, 2012 | By Tina Susman
Raymond Roth accomplished a lot while supposedly dead, police say. He drove to Florida, got a speeding ticket in South Carolina, and sent emails to his son back home in New York. On Wednesday, he added another feat to the list: He was arrested on charges of insurance fraud in a case that has highlighted a faked death gone comically awry, and dysfunctional family woes. A day after his 22-year-old son, Jonathan, who is charged in the same case, was released on bond, the elder Roth faced arraignment in a Long Island court after a bizarre odyssey that began with a supposed swim off Jones Beach on July 28. Roth, 47, never came out of the water, his apparently distraught son told police when he called to report his dad missing that evening.
July 22, 2012 | Michael Hiltzik
The relationship between charities and philanthropists in the business community is governed by a sort of Newtonian law of equal and opposite benefits. The charities get money, goods or services. Their donors get self-satisfaction, community goodwill (which might mean more customers coming in the door), and positive character references to display to jurors, regulators or congressional subcommittees, if necessary. How much of that might apply to a newly formed Los Angeles philanthropy called No More Poverty?
February 2, 2012 | By Stuart Pfeifer and W.J. Hennigan, Los Angeles Times
The maker of the Lap-Band will no longer sell its product to clinics affiliated with the 1-800-GET-THIN marketing company - a blow to Southern California surgery centers that have built an empire implanting the weight-loss devices in people looking to shed pounds. Allergan Inc. said in a statement that it has "made the decision to presently discontinue the sale of the Lap-Band … to all entities affiliated with 1-800-GET-THIN. " The Irvine company's action Thursday comes amid state and federal investigations of surgery centers affiliated with 1-800-GET-THIN, which touts the Lap-Band procedure on Southland freeway billboards and on TV, radio and the Internet.
January 26, 2012 | By Stuart Pfeifer, Los Angeles Times
The California Department of Insurance is investigating the business practices of Lap-Band surgery centers affiliated with the 1-800-GET-THIN advertising campaign, according to insurer Aetna Inc. The insurance giant said in a statement that it was cooperating with the department's law enforcement branch, which has the power to make arrests and pursue criminal charges, to "investigate alleged fraud against our members by the 1-800-GET-THIN … surgery...
October 5, 2011 | By Michael Hiltzik, Los Angeles Times Staff Writer
Jessica Bleaman, 21, responded in 2009 to an ad from 1-800-GET-THIN, the outfit that has been touting weight-loss surgery incessantly in the Southland via broadcast commercials and freeway billboards. Her experience with the gastric-banding purveyors didn't turn out well, but her alleged medical problems were only part of it. For months after her surgery, she said, she suffered pain and vomiting, and in 2010 she underwent a second operation at a clinic affiliated with the billboard campaign.
August 5, 2011 | By Corina Knoll, Los Angeles Times
A 65-year-old doctor was convicted Thursday of performing unnecessary and dangerous surgeries on more than 160 people in a $154-million medical insurance scam that lured patients by promising them cash or low-cost cosmetic surgeries. Dr. Michael Chan of Cerritos, one of 19 defendants accused of fraudulently billing medical insurance companies, pleaded guilty in Orange County Superior Court to 40 felony counts, including conspiracy to commit insurance fraud and insurance fraud. He faces up to 28 years in state prison.
July 19, 2011 | By Robert Faturechi, Los Angeles Times Staff Writer
Several Los Angeles County sheriff's deputies have been entangled in fraud allegations in the last year, a spike that the department's watchdog says may be linked to overtime cuts pushing cash-strapped deputies to commit crimes. One deputy torched his own car for an insurance payout, another fabricated a burglary and a third enlisted a fellow cop to help him drive his car to Mexico, where he abandoned it and later claimed it was stolen. Two other deputies are facing federal charges in an alleged mortgage fraud scheme, according to the report provided to The Times on Monday by the Office of Independent Review.
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