SANTA ANA More than two dozen doctors, pharmacists and business owners were charged on Thursday in an alleged $40 million medical-insurance scam that played out 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 scheme in which they recruited doctors and pharmacists to prescribe unnecessary treatments for patients on workers’ compensation.
“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. “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, according to the Orange County District Attorney’s Office.
Prosecutors alleged 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.
The alleged scam victimized more than 13,000 patients and at least 27 insurance carriers, prosecutors said. Authorities said about $23.2 million was paid to the Kings, while a total of $40 million was billed to insurers.
Prosecutors said the Kings made oral and written agreements with doctors throughout California, including in Orange County, to pay them each time they prescribed an unnecessary cream or medication. The doctors are accused of labeling the payment kickbacks as “marketing expenses.”
The alleged schemes included:
— Snake Oil Scam: The Kings are accused of working with co-defendants Charles Bonner, 56, and Mervyn Miller, 66, the owners of Steven’s Pharmacy in Costa Mesa, to manufacture creams that “did nothing” and were not FDA approved. The Kings are accused of paying $15 to $40 per tube of compound cream and billing insurance companies $250 to $700 per tube.
The Kings are accused of paying $15 to $40 per tube of compound cream and billing insurance companies $250 to $700 per tube.
— Medication Kickback Scam: The Kings are accused of purchasing repackaged oral-pain medications from Orange County outfits. They would then send the medications directly to the physicians.
When the medications were prescribed, the Kings allegedly billed workers’ compensation carriers without disclosing the wholesale costs and then split the profits with the physicians.
— Bogus Urine Test Scam: The Kings are accused of providing technical staff…