The owner and sole physician of a medical clinic in Bellflower, Calif., pleaded guilty to a scheme that submitted more than $4.6 million in fraudulent claims to Medi-Cal.
Robert Eyzaguirre, MD, 77, of Torrance, Calif., pleaded guilty to one count of healthcare fraud, which carries a maximum sentence of 10 years in prison, according to a May 7 Justice Department news release.
From December 2013 through January 2020, Dr. Eyzaguirre and two of his employees submitted more than $4.6 million to a Medi-Cal program for family planning services that were never provided, according to the release. An employee created fake patient files with fake vitals and patient notes, which were then signed by Dr. Eyzaguirre and submitted to the program. Medi-Cal paid more than $2.5 million on the fraudulent claims.
He also falsely certified that the fake patient files that laboratory tests were medically necessary, according to the release. The employees then referred the names of fake patients to a laboratory in Northern California, which paid an illegal kick of $30 cash for each referral. The lab paid more than $372,000 in illegal kickbacks for the referrals from the medical clinic. Medi-Cal paid more than $1 million on the fraudulent claims submitted by the lab.
When Dr. Eyzaguirre learned law enforcement was investigating the scheme, he instructed an employee to hide the files offsite, according to the release.
Dr. Eyzaguirre is scheduled to be sentenced Oct. 28.