OxyContin Insurance Fraud Scheme Alleged in Los Angeles
A recent Los Angeles Times article lays out charges filed against 14 people, including an elderly doctor, who allegedly participated in an illegal OxyContin insurance fraud scam.
"Pill mills" and other prescription drug-based crimes are on the rise in the United States as law enforcement has changed its focus from heroin and cocaine level drugs to prescription drugs as buyers and sellers change their preference.

But in the past, the only people charged in drug crimes in Los Angeles were the buyers and sellers and maybe a few distributors.
Today, more and more people are getting wrapped up in Los Angeles insurance fraud cases alleging that they, doctors, pharmacists and others were involved in schemes to not only illegally sell prescription drugs, but to defraud insurance companies at the same time. Los Angeles insurance fraud defense lawyers must be consulted if a situation like this arises.
According to the Times, a two-year investigation revealed that more than a dozen people allegedly participated in the scheme, largely based on insurance fraud.
A federal indictment alleges doctors wrote prescriptions for the painkiller to uninsured patients who didn't need it. The conspirators also got pills from pharmacies by fraudulently billing insurance companies, including the publicly run Medicare.
According to investigators, the pills were resold for $23 to $27 per pill and they sold more than 1 million pills. Identity theft and Medicare beneficiary information theft was also alleged as part of the scam.
Along with clinic operators, two doctors, aged 88 and 73, are accused of participating. Recruiters, pill runners or fake patients are the others accused in connection with the alleged operation. Initially, 10 of the 14 were arrested, while authorities looked for the remaining defendants.
The accused are charged with drug conspiracy or healthcare fraud. One of the clinic operators also is charged with wholesale distribution of OxyContin. The defendants face a maximum of 10 to 40 years in prison.
Insurance fraud is simple in concept, but complex on a case-by-case basis. Insurance fraud in Los Angeles is simply defrauding an insurance company through false pretenses. In situations like these, it means filing claims with insurance companies for drugs that a person doesn't need or setting up claims on behalf of a person whose identity has been stolen.
When drugs are involved, the case can become more complex, because potential drug laws could be broken in the process as well, adding to the possible penalties and attracting more attention from authorities fighting the "War on Drugs."
Insurance fraud in California can be different than federal charges of fraud. The penalties can vary and the elements of the crime are different as well. Being charged in state versus federal court can make a big difference for a defendant in terms of penalties, how the case plays out and how the sentencing is handled.
Continue reading "OxyContin Insurance Fraud Scheme Alleged in Los Angeles" »









