3 California physicians charged in $580M billing fraud scheme

Three physicians have been charged for their alleged roles in a healthcare fraud scheme that resulted in the submission of more than $580 million in fraudulent claims, mostly to California's worker compensation system, according to the Department of Justice.

The three physicians, David Payne, MD; Jeffrey Gross, MD; and Lokesh Tantuwaya, MD, were charged in relation to the government's investigation into kickbacks physicians received for patient referrals for spinal surgeries performed at Pacific Hospital in Long Beach, Calif. They are among the dozens of physicians and other medical professionals allegedly involved in the scheme.

According to the DOJ, Dr. Payne received approximately $450,000 in bribes to steer more than $10 million in surgeries to Pacific Hospital. On June 14, he was arraigned on charges of conspiracy, honest services fraud and using an interstate facility to aid in unlawful activity.

Dr. Gross allegedly received $622,000 in bribes in exchange for performing or referring more than $19 million in surgeries to Pacific Hospital. On June 13, he pleaded not guilty to charges contained in a 14-count indictment returned earlier this year by a federal grand jury.

Dr. Tantuwaya was allegedly paid $3.2 million in bribes in exchange for performing or referring more than $38 million in surgeries to Pacific Hospital. He was charged in a 13-count indictment in February and pleaded not guilty in April. His trial is slated for November.

Michael Drobot, former owner and CEO of Pacific Hospital, ran the 15-year-long kickback scheme. He was sentenced to more than five years in prison in January. To date, nine defendants have been convicted for participating in the kickback scheme.

More articles on legal and regulatory issues:

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