DOCTOR SENTENCED TO 16 YEARS IN PRISON FOR PERFORMING UNNECESSARY SURGERIES ON HEALTHY PATIENTS IN $154 MILLION MEDICAL INSURANCE FRAUD SCHEME

OCDASeal

Orange County District Attorney
Press Release


Tony Rackauckas, District Attorney
401 Civic Center Drive West
Santa Ana, CA 92701

For Immediate Release
Case # 08ZF0025

 


 

May 8, 2009

Susan Kang Schroeder
Public Affairs Counsel
Office: 714-347-8408
Cell: 714-292-2718

Farrah Emami
Spokesperson
Office: 714-347-8405
Cell: 714-323-4486

DOCTOR SENTENCED TO 16 YEARS IN PRISON FOR PERFORMING UNNECESSARY SURGERIES
ON HEALTHY PATIENTS IN $154 MILLION
MEDICAL INSURANCE FRAUD SCHEME

 

SANTA ANA – A doctor charged in the largest medical fraud prosecution in the nation was sentenced today to 16 years in state prison for performing unnecessary and dangerous surgeries on over 175 patients in order to fraudulently bill medical insurance companies. William Wilson Hampton, Jr., 53, Seal Beach, pleaded guilty to 47 felony counts including conspiracy, insurance fraud, and capping.

 

The Unity Outpatient Surgery Center (Unity) scheme, in which $154 million was fraudulently billed to medical insurance companies, was a joint investigation by the California Department of Insurance and Orange County District Attorney’s Office with assistance from the California Franchise Tax Board (CFTB).

 

Of the 19 defendants charged in the Unity case, 13 were indicted by a criminal grand jury on June 13, 2008. The Orange County Grand Jury examined 1,054 exhibits and heard testimony from 56 witnesses over 28 days, resulting in a 70-page indictment. The indicted defendants include an attorney, accountant, three doctors, and patient recruiters known as “cappers.”  Hampton is the second indicted defendant to plead guilty. Capper Sue Nanda, 40, Costa Mesa, pleaded guilty Feb. 20, 2009, to 22 felony counts and is expected to be sentenced to up to 20 years in state prison on June 1, 2009. The other six defendants in the Unity case pleaded guilty prior to the indictment and have been sentenced. The remaining 11 defendants are scheduled for pre-trial on June 5, 2009, at the Central Justice Center in Santa Ana.  

 

Deputy District Attorneys George McFetridge and Rick Welsh of the Healthcare Insurance Fraud Unit are prosecuting this case.

 

“A sweaty palm surgery requires a patient to undergo general anesthesia, where the doctor will collapse a lung to clamp a nerve right next to the spine. It is dangerous, almost always unnecessary, and may result in terrible side effects,” stated District Attorney Tony Rackauckas.  “It is outrageous that a doctor would cut into healthy patients and use their bodies as cash registers.”

 

“Insurance fraud is never a victimless crime, and this especially deplorable scheme had the potential to injure otherwise healthy people,” said Insurance Commissioner Steve Poizner. “We’ll continue to work with our local partners to find and prosecute those who would try to defraud the insurance system for personal gain.”

“It’s rewarding to know state and local governments can work together to stop these serious crimes and protect individuals who depend upon affordable healthcare services. FTB is proud to stand shoulder to shoulder with Tony Rackauckas,” said John Barrett, Franchise Tax Board Public Information Spokesman.

 

Case Overview

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.