Randy Rosen, MD, a former anesthesiologist in Beverly Hills, Calif., has been sentenced to 10 years in prison for stealing nearly $38 million through an insurance fraud scheme that paid patients at sober living homes to undergo medically unnecessary testing and surgeries.
On Aug. 12, Mr. Rosen, 59, pleaded guilty to eight counts of insurance fraud and two aggravated white collar crime enhancements in two separate cases relating to the recruiting and hiring of body brokers to "find and pay patients to have medically unnecessary naltrexone implant surgeries and cortisone shots," the Office of the Orange County District Attorney said in an Aug. 16 news release.
The prison sentence is the largest any provider has received for California workers' compensation insurance fraud.
Prosecutors said Mr. Rosen billed several insurers for unnecessary procedures performed on drug-addicted patients who were not told that patients were being trafficked and paid for the procedures. About $600 million was fraudulently billed to insurers, which paid out about $50 million.
In addition to subjecting patients to unnecessary procedures, Mr. Rosen also required them to undergo drug tests which he sent to Lotus Laboratories in Los Alamitos, Calif., owned by his girlfriend, Liza Visamanos, 43, for testing. Prosecutors allege Lotus fraudulently billed at least 22 insurers more than $3 million.
Mr. Rosen was also ordered to pay $9.1 million in restitution. Ms. Visamanos pleaded guilty to two felony charges of insurance fraud and was sentenced to one year of home confinement, formal probation and ordered to pay restitution.
"Dr. Rosen used vulnerable sober living patients who were desperately trying to battle their demons as an ATM machine to make a buck. He didn’t care about his patients; he only cared about making as much money as possible," Orange County District Attorney Todd Spitzer said. "I refuse to allow these body brokers to traffick human beings as part of a thinly disguised plot to strike it rich."