SANTA ANA — More than two dozen doctors, pharmacists and business owners, including several from the East Bay, were charged Thursday in a suspected $40 million medical-insurance scam in Orange County and elsewhere that officials said “played with patients’ lives.”
The accused masterminds are Beverly Hills couple Tanya Moreland King, 37, and husband Christopher King, 38, who own medical-billing and medical-management companies Monarch Medical Group, King Medical Management and One Source Laboratories.
Authorities said the couple carried out a complex insurance fraud in which they recruited doctors and pharmacists to prescribe unnecessary treatments for patients on workers’ compensation.
Four of the doctors named in the case are from Pleasanton: Dr. Chris Chen, 55; Dr. Eduardo T. Lin I, 55; Dr. Mannie Joel, 67; and Dr. Parvez Fatteh, 46. Dr. Mohamed Ibrahim, 40, of Danville, is also named as a defendant.
“The Kings and their co-conspirators played with patients’ lives, buying and selling them for profit without regard to patient safety,” State Insurance Commissioner Dave Jones said in a news conference Thursday in Orange County. “The magnitude of this alleged crime is an affront to ethical medical professionals.”
The Kings, along with 21 doctors, one physician assistant and two pharmacists, face a string of felony charges, including insurance fraud, filing false and fraudulent claims, and conspiracy to commit medical-insurance fraud.
Prosecutors allege that the Kings, from 2011 through 2015, billed for unnecessary creams, tests and treatments to gain profits. The alleged scam victimized more than 13,000 patients and at least 27 insurance carriers, prosecutors said. Authorities said that about $23.2 million was paid to the Kings, while a total of $40 million was billed to insurers.
Chen and Lin, both of Pleasanton, were charged with four counts, including conspiracy to commit medical insurance fraud, filing a false and fraudulent claim and insurance fraud, according to the Orange County District Attorney’s Office. Both have two enhancements that allege the property loss was over $200,000 and that they committed an aggravated white-collar crime over $500,000.
Chen is trained in pain management, and received special training in car and motorcycle accident reconstruction, according to his website. He has offices in Pleasanton, San Mateo, Pinole and Sacramento. He did not respond to a request for comment.
Lin is part of the Sutter Health network and operates out of an office in Pleasanton. He specializes in physical medicine and rehabilitation, including acupuncture and back pain. He received his medical training in Sao Paulo, Brazil, according to the Sutter Health website.
Ibrahim, an orthopedic hand surgeon, operates out of Modesto and is also part of the Sutter Health network. He attended medical school in Cairo, Egypt. His charges also include insurance fraud, with the two enhancements that allege the property loss was over…