REAL doctors performed real procedures on real patients. The insurance claims were real; so were the surgery centers that filed them. And the money that insurers paid - a total of about $500 million, federal investigators estimate - was most assuredly real.
Hundreds of people, many of them recent immigrants unfamiliar with America's health care system, volunteered to undergo the medical tests and operations. They traveled to surgery centers in Southern California for what would be, in another context, routine procedures like endoscopies, colonoscopies and pap smears. Some traveled, on the clinics' dime, from as far away as Tennessee. Some of them, investigators say, received free or discounted plastic surgery, and others got cash.
Any such payment was and is illegal.
Insurers, meanwhile, were billed tens of thousands of dollars for each procedure, far more than they would have paid if the patients had gone to in-network providers.
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# posted by madthumbs @ 12:17 PM
