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OC district attorney charges surgeon, girlfriend with sober living home insurance fraud

A Beverly Hills surgeon and his girlfriend have pleaded not guilty to charges of stealing nearly $52 million in an elaborate insurance fraud scheme that involved hiring body brokers to pay patients at Southern California sober living homes to undergo medically unnecessary surgeries, medical testing and other medical procedures, officials said Friday, July 3.

Dr. Randy Rosen pleaded not guilty Thursday to 88 felony counts in two separate cases, while Rosen’s girlfriend — 41-year-old Liza Visamanos of Los Angeles — pleaded not guilty to 56 felony counts in two separate cases in connection with the scheme.

The pair were arrested Tuesday, with bail originally set at $52 million. On Thursday, a commissioner reduced Rosen’s bail to $15 million in one case and $1 million in the other case. Visamanos’ bail was reduced to $3 million in one case and $100,000 for the second case. Both defendants will be on GPS monitoring, according to the Orange County District Attorney’s Office.

Rosen’s attorney, Harland Braun, ridiculed the original $52 million amount of bail on Wednesday. “How can you have bail of $52 million when murder is $1 million bail?” Braun asked.

Vismanos’ attorney, Paul Meyer, declined comment.

Multimillion-dollar fraud scheme

According to a motion to increase the pair’s bail, investigators alleged Rosen was “indicted for his role in a multimillion-dollar fraud scheme and is currently out on bail for that case.”

Braun said Rosen was involved in another case in Orange County Superior Court in which a judge found an investigator breached attorney-client privilege, and that case is pending.

The pair allegedly recruited and hired numerous body brokers to find and pay patients to have medically unnecessary naltrexone implant surgeries and cortisone shots. Prosecutors say several insurance companies were then billed for these unnecessary procedures and were never informed of the fact that patients were being trafficked and paid for them.

The insurance companies were allegedly fraudulently billed approximately $600 million and paid out approximately $50 million.

In addition to submitting patients to medically unnecessary procedures, it is alleged Rosen also required the patients to undergo unnecessary drug tests that he sent to Lotus Laboratories, which is owned by his girlfriend, for testing. California law prohibits such referrals where the physician or his immediate family has a financial interest with the person or entity receiving the referral. It is alleged that Lotus Laboratories fraudulently billed at least 22 different insurance providers more than $3 million.

Four others have been charged in connection with the case. Robert Mellon, 52, of San Diego; Thomas Douglas, 29 of Playa del Rey; Shea Simmons, 28, of Jeanerette, Louisiana; and Patrick Connolly, 28, of Los Angeles, also face felony charges for their involvement in the scheme, DA’s officials said.

‘Twisted plot’ to line pockets

“Vulnerable sober living patients who were trying desperately to battle their addictions were treated like human guinea pigs just to make a buck,” Orange County District Attorney Todd Spitzer said. “I refuse to allow these body brokers to exploit and traffic human beings as part of a sick and twisted plot to line their own pockets. This prosecution is a testament to the dedicated work of our prosecutors and our Bureau of Investigation to hold these real-life Frankensteins accountable.”

Rosen was involved in a civil federal lawsuit involving a health care fraud scheme at a Long Beach hospital that was settled in 2017.

He is charged with crimes ranging from money laundering and submitting false documents to conspiracy to commit unlawful patient referrals and withholding material facts on insurance claims. If convicted on all counts, he faces a maximum of 84 years and eight months in state prison, prosecutors said.

Vismanos is charged with a similar range of crimes and, if convicted, faces a maximum of 36 years and four months in state prison.

Source: Orange County Register

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