When seeking treatment for health issues, many patients rely on health insurance to cover at least part of the cost. The cost for ongoing treatment for certain conditions, including drug and alcohol addiction, can quickly become overwhelming, especially when a patient’s policy requires high premiums and deductibles. Recently, the owner of one drug treatment facility was charged with white collar crimes that include fraudulently setting up insurance policies for his patients.
The man is the owner of a California detox and treatment facility that offers inpatient and outpatient services to those seeking recovery from substance abuse issues. Reports say the man purchased policies for 30 patients, making the first premium payments for more than half of them. He is accused of then billing the insurer for the treatment of those patients. The insurer paid the man the full amount of the bills because the man claimed his patients had met their deductibles.
When interviewed, the patients denied having taken out policies with the insurance company. They say the owner of the facility never charged them for services, did not collect a deductible and did not require a copay. He is accused of receiving over $250,000 from the insurance company for fraudulent claims, charges for which the man insists he is not guilty.
In addition to charges of insurance fraud, California authorities added an aggravated white collar crimes enhancement. This enhancement means the man faces the potential of additional penalties, including prison time and fines. Having a strong criminal defense strategy may result in a more positive outcome for those charged with similar offenses.