|For Immediate Release
Case # 08ZF0025
February 20, 2009
|Susan Kang Schroeder
Public Affairs Counsel
CAPPER PLEADING GUILTY IN THE LARGEST MEDICAL INSURANCE FRUAD CASE IN THE NATION MAY BE SENTENCED TO 20 YEARS
SANTA ANA – A capper’s involvement in the largest medical insurance fraud case in the nation, also known as the Unity Outpatient Surgery Center (Unity) scheme, in which $154 million was fraudulently billed to medical insurance companies, pleaded guilty today to 22 felony counts. Sue Nanda, 40, Costa Mesa, pleaded guilty to one felony count of conspiracy, nine felony counts of capping, two felony counts of failing to file tax return, one felony count of filing a fraudulent tax return, one felony count of grand theft, and sentencing enhancements for white collar crime. Under the negotiated plea, Nanda will receive up to 20 years in state prison when she is sentenced on April 24, 2009, at 9:00 a.m. in Department C-35, Central Justice Center, Santa Ana. This was a joint investigation and prosecution by the California Department of Insurance, the California Franchise Tax Board, and the Orange County District Attorney’s Office. On June 13, 2008, following a 3-month hearing, with over 50 witnesses, the Orange County Grand Jury delivered a 70-page indictment of 13 defendants including an attorney, an accountant, three doctors, and cappers.
There are 19 total defendants who have been charged in the Unity case. Aside from Nanda, six defendants have pleaded guilty and have been sentenced. Deputy District Attorneys George McFetridge and Rick Welsh of the Healthcare Insurance Fraud Unit are prosecuting this case.
The rest of the indicted defendants are scheduled for a pre-trial on Feb. 27, 2009, at 9:00 a.m. in Department C-35, Central Justice Center, Santa Ana
“Insurance fraud is not a victimless crime and costs $500 a year to every man, woman and child in California,” said Insurance Commissioner
Steve Poizner. “This is a great example of what happens when government works together. I want to thank the Orange County District Attorney’s office, the
Department of Insurance’s enforcement branch, and all those involved for their hard work in this case. I hope this sends a message to all of
those contemplating insurance fraud that we will work together to find you and prosecute you.”
“These types of crimes cannot occur without these cappers illegally rounding-up healthy, so-called patients, bringing them to doctors for unnecessary surgeries, and ripping off the health care system and the public,” said Orange County District Attorney Tony Rackauckas. “This Unity fraud amounts to the equivalent of stealing $50 from every citizen in Orange County. It must be stopped.”
The newest evidence in the Unity case was presented to the Orange County Grand Jury beginning March 4, 2008, and concluded with a sealed indictment on June 13, 2008. The defendants in the Unity case are accused of participating in a $154 million medical insurance fraud scheme that recruited 2,841 healthy people from all over the country to receive unnecessary surgeries in exchange for money or low cost cosmetic surgery. The recruitment of patients, or “capping,” is illegal in California. Insurance companies paid out more than $20 million during a 9-month period. The first three charged administrators, Tam Vu Pham, Huong Ngo, and Lan Nguyen, have pleaded guilty. Pham, the primary perpetrator, was sentenced to 12 years in state prison.