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Los Angeles, California - Over the past 10 months, the Department of Justice has filed criminal charges against 10 defendants for kickback schemes at substance abuse treatment facilities in Orange County, California.

The defendants in these cases are substance abuse facility owners and patient recruiters who allegedly, among other things, provided kickback payments for the referral of patients to substance abuse treatment facilities, recovery homes or laboratories. These facility owners allegedly assigned a value to patients depending on the type of insurance the patients had and paid patient recruiters kickbacks for each patient the recruiters referred to their addiction treatment facilities. The recruiters allegedly received recurring payments for each month the patients continued to receive purported services from the facilities.

“These cases reflect the continued efforts of the Department of Justice to combat fraud by substance abuse treatment facilities and patient recruiters,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “These schemes take advantage of vulnerable members of our society — addiction patients seeking help. These cases illustrate, the government’s commitment to protecting patients and prosecuting those who try to victimize them.”

“Driven by greed, dishonest operators of substance abuse treatment centers have invaded Southern California, but a coalition of law enforcement entities have responded forcefully,” said U.S. Attorney Tracy L. Wilkison for the Central District of California. “These corrupt individuals pay illegal kickbacks to obtain insured patients whose health plans pay generous benefits intended to cover legitimate treatments and tests. While many recovery facilities offer much-needed services to addicts, those targeted in this sweep take advantage of our nation’s opioid crisis by fueling a patient-selling network more interested in generating profits than giving help to vulnerable people.”

“The defendants in these cases were more interested in extracting profits and exploiting patients than helping those in need,” said Acting Assistant Director Jay Greenberg of the FBI’s Criminal Investigative Division. “Kickback schemes undermine the integrity of our health care system by rewarding a focus on profits over patient care. The FBI and our law enforcement partners are committed to protecting America’s health care system and the citizens relying on it.”

“It is unconscionable when owners and operators of substance abuse facilities abuse the systems designed to help patients recover from addiction,” said Special Agent in Charge Amy K. Parker of the Office of Personnel Management Office of the Inspector General (OPM-OIG). “We are extremely proud of our dedicated staff and federal law enforcement partner’s commitment to pursuing improper and illegal conduct that places vulnerable health care consumers at risk.”

“The suspects in this case specifically targeted vulnerable individuals in recovery and sold them as a commodity with no concern for their health or wellbeing,” said California Insurance Commissioner Ricardo Lara. “Receiving kickbacks for patient referrals endangers lives and has no place in our health care system.”

Case Summaries

A federal district court judge will determine any sentence for the defendants after considering the U.S. Sentencing Guidelines and other statutory factors.

The Sober Homes Initiative in Southern California is led by the Health Care Fraud Unit’s Los Angeles Strike Force of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California, and was coordinated by Assistant Chief Niall O’Donnell of the Health Care Fraud Unit and Benjamin Barron, Chief of the U.S. Attorney’s Office’s Santa Ana Branch Office. 

The FBI Los Angeles Field Office, OPM-OIG, and the California Department of Insurance are investigating the cases.

An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.