Giant Medical Scam|Alleged in Los Angeles

     LOS ANGELES (CN) – An L.A.-based orthopedic surgeon was arrested Monday in Germany and charged with masterminding a $150 million scam the district attorney calls one of the largest insurance fraud cases in California history.
     Dr. Munir Uwaydah, 49, of Frontline Medical, is being held for extradition to the United States. Fourteen others are charged in two indictments with a total of 132 felony counts, including Uwaydah’s attorney, 45-year-old Tatiana Arnold.
     “Today, we put an end to the illegal activities of an organized criminal enterprise that was responsible for one of the largest insurance fraud scams in California’s history,” L.A. County District Attorney Jackie Lacey said Tuesday.
     Lacey called it a “vast conspiracy,” in which Uwaydah billed insurance companies more than $150 million for surgeries he did not perform. He paid attorneys and marketers up to $10,000 apiece for patient referrals in an illegal practice known as “capping,” according to the indictments.
     More than two dozen patients had surgeries that were not performed by Uwaydah, as they were led to believe, but by a physician assistant who never been to medical school, prosecutors said.
     Uwaydah was not in the operating room when the assistant performed the operations on patients, according to the indictment. The patients were left with scarring and required more surgery for their “physical and psychological trauma,” according to Lacey’s office.
     Insurance authorization reports were written to justify surgeries, some of which were performed though there was no need for them, prosecutors said. Also fraudulent were billings for prescription medications and office visits, Lacey said.
     “Although the patient victims sustained physical harm, we who pay higher premiums for health care suffer economic harm when scams are allowed to continue unchecked,” Lacey said.
     The 5-year investigation included testimony from 102 people in two grand jury proceedings this year.
     Uwaydah et al. were charged with conspiracy, insurance fraud, aggravated mayhem and capping. Uwaydah faces up to life in state prison if convicted.
     The 57-count indictment returned on Feb. 25 names as defendants Uwaydah, Arnold, Paul Turley, Maria Turley, Marisa Schermbeck-Nelson, Peter Nelson, David Johnson, Leticia Alvarez Lemus, Jeff Stevens, Wendee Luke, Kelly Park, Ron Case, Terry Luke, Tony Folgar and Yolanda Groscost.
     A 75-count indictment returned on Aug. 26 names as defendants Arnold, Luke, Folgar and Groscost.

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