A Beverly Hills physician and his girlfriend admitted on Friday to running a million dollar medical insurance scam after making their fortune off of helpless addicts in recovery.
In their renowned operation, Dr. Randy Rosen and Liza Vismanos paid residents of many Southern California sober living facilities to undergo medically unnecessary implant procedures and get cortisone injections.
Prior to their arrest in 2020, the couple worked together to defraud insurance providers of around $676 million for unneeded medical treatments and drug testing of individuals they attracted to their clinics.
They had collected $52 million from the insurance companies at the time of their arrest.
Rosen pleaded guilt to making false medical insurance claims on August 12 and was sentenced to 10 years in prison, according to The OC Register. The surgeon was freed when many additional accusations were dropped.
Vismanos, meanwhile, admitted to defrauding medical insurance and had several additional counts dropped. She is under home confinement.
According to a statement from the Orange County District Attorney, “This is the biggest jail term for a provider in a California workers’ compensation insurance scam.”
“Dr. Rosen utilised helpless patients in sober living facilities who were valiantly battling their demons as an ATM machine to gain money.”
He didn’t care about his patients; all that mattered to him was becoming rich quick.
Vismanos oversaw the toxicology laboratory at Lotus Laboratories in Los Alamitos, while Rosen supervised a surgery facility named Wellness Wave.
The surgeon paid patients to take drug tests at Vismanos’ lab, which caused her to submit more than $3 million in claims to at least 22 different insurance companies.
To keep their patients from relapsing into drug and alcohol use, the pair attempted to sell them cortisone injections and Naltrexone implants.
By providing incentives or a share of the insurance reimbursement in exchange for undergoing certain operations, the patients would get involved.
According to court filings, the pair allegedly selected sober living facilities because Southern California had a “big market” for them.
Since state-wide insurance companies are compelled to pay for medical expenditures, including the price of sober living homes, owners of these facilities and physicians may earn millions off of their patients.
According to court papers, “a doctor may easily take advantage of the fragility of drug addicts by neglecting the patient’s need for complete therapy (mental and physical) to get well.”
In order to enhance their profits, physicians often collaborate with the managers of sober living facilities, other drug users, and what are known as “body brokers.”
According to surgery records from Rosen’s office, he averaged over 72 operations every day, with the shortest one taking only one minute to complete.
Prosecutors claim that the treatment may be successfully completed in 15 minutes for a cost of roughly $4,000.
The physician, called the “real life Frankenstein” by District Attorney Spitzer, was detained and lodged in the Orange County prison while rebuilding a $3.2 million property in the hills of Brentwood, Los Angeles.
According to The OC Register, the million dollar estate has a lap pool, a wine cellar, and breathtaking vistas of downtown Los Angeles, the Santa Monica Mountains, and the Pacific Ocean.
The pair bought expensive stuff with their stolen money, including as luxury automobiles, jewellery, works of art, handbags, and bars of gold and silver.
Medical professionals are prohibited from making recommendations in California if doing so will financially benefit them or a member of their close family.
The two disregarded governmental regulations and were even thought to have assistance from accomplices.
Other individuals who were alleged to have collaborated with the couple were detained in 2020.
Robert Mellon, 52, Thomas Douglas, 29, Shea Simmons, 28, and Patrick Connolly, 28, are the other four suspects.
They are accused of serving as Rosen’s “body brokers” and “selling” him the “human guinea pigs.”
According to authorities at the time of Rosen’s arrest, the scam may have caused the deaths of 35 patients, many of whom died from overdoses.