Six From OC Charged as Part of $40 Million Statewide Medical Insurance Fraud Scheme

Orange County District Attorney Tony Rackauckas (left) and State Insurance Commissioner Dave Jones at a news conference April 20 where they announced 26 California medical professionals were charged in a $40 million insurance fraud scheme.

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State Insurance Commissioner Dave Jones and county District Attorney Tony Rackauckas said Tuesday the DA’s office charged 26 California medical professionals in a $40 million insurance fraud scheme that includes a Costa Mesa pharmacy and four Orange County doctors.

“Insurance fraud is often times referred to as a victimless crime, but as you can see from this case, there are many victims,” Jones told a news conference where the charges were announced. According to a news release, 13,000 patients and 27 insurance carriers were victims of the scheme between 2011 and 2015.

“Now these are very egregious crimes when the health of individuals is put at risk because the physician is getting a kickback and that kickback is determining whether they are prescribing medications,” Jones said. “That undermines the very system of medical care.”

Tanya and Christopher King of Beverly Hills, owners of medical billing and management companies Monarch Medical Group, Inc. King Medical Management, Inc. and One Source Laboratories are accused of masterminding the scheme that billed insurance companies $40 million of which the Kings received $23 million and paid physicians and pharmacists.

In addition to the Kings, charges were filed against 21 doctors from throughout the state, one physician’s assistant and two pharmacists.

Pharmacists Charles Bonner, 56 and Mervyn Miller, 66, both of Irvine, are accused of conspiring with the Kings and selling more than $1 million in creams that have no known medical benefits and are not FDA approved. They are co-owners of Steven’s Pharmacy in Costa Mesa.

Tanya King recruited doctors to prescribe the creams to their patients by either paying the physicians a flat rate of $50 per tube or a share in the profits, according to a news release.

“Fraud, as you know, drives up the cost of medical care … and affects the ability to conduct business in California. And so, you know, we really do need to stay on top of it,” Rackauckas told the news conference.

The Kings bought the creams from Steve’s Pharmacy, which, according to the DA and Jones, mass produced thousands of creams at $15 to $40 per tube and paid doctors for prescribing them. The patients’ workers’ compensation insurance was billed anywhere from $250 to $700 for each tube whenever a doctor prescribed it for a patient, according to the DA’s office.

The DA’s office also is accusing the Kings of running a kickback scam that involved repackaging oral pain medication from NuCare Pharmaceuticals in Orange and AS Medication Solutions in Costa Mesa.

The medication was sent directly to the doctors who prescribed it and was billed to workers’ compensation insurance companies without the Kings disclosing to the insurers the wholesale cost of the medication or the fact it was bought on behalf of the prescribing doctors.

“This primal conduct helps drive the … price of insurance up,” Rackauckas said. “Not exactly a mystery on why our medical premiums are so high.”

The third scheme that state insurance investigators and DA’s office said they found was bogus urine tests. Doctors used King-owned One Source Laboratories to unnecessarily test their patients who had workers compensation insurance to make sure they were taking their prescriptions, Rackauckas said.

Regardless of the results from the King’s One Source Lab, the results were sent to Pacific Toxicology Laboratory for additional testing. Through their One Source Lab, the Kings paid Pacific a flat rate of $60 per test and billed insurance companies hundreds of dollars per patient.

“Not satisfied with the profits of one test, the results were then referred to Pacific Toxicology Laboratory for additional testing, regardless of the results,” Rackauckas said.

Tanya King could face up to 117 years in prison. No estimated sentence was given for Christopher King. Pharmacists Bonner and Miller each could get up to a 28-year sentence and the 21 physicians and one physician assistant could face up to 25 years in prison.

“They violated their oath as physicians and they violated the law,” Jones said.

The four Orange County doctors among the 21 physicians charged are: Dr. Duke Anh, 49, Los Alamitos, received $80,000; Dr. Kevin Park, 49, Buena Park, was paid $45,000; Dr. Ismael Silva Jr., 63, Newport Coast, received $345,000, and Dr. Ismael Geli Silva, 38, Huntington Beach, made $345,000.

In total, the investigation alleges over $2.1 million was paid to the 21 physicians.

Spencer Custodio is a Voice of OC intern. He can be reached at spencercustodio@gmail.com.

 

  • Ed Romero

    What I don’t understand about this is. Why does it take SO LONG to figure out something is going on. I remember confronting my Mother’s Doctor about him REMOVING stickers from her Medical Card that she didn’t use, like a Hospital visit that she never took or an Ambulance that she never used. He threw me out of his Office and said “don’t ever return here again”. I was employed by the County of Orange at that time so I contacted someone about this possible Insurance Fraud. NOTHING was done about it. After my Mother’s death I again made contact, apparently other people had too. He was investigated and convicted, he spent time in Jail, had to repay Medicare/Medical, and was fined. After he got out of Jail he went back to being a Doctor again. I hope they are keeping an eye on him. There was another Doctor here in San Juan Capistrano and the line outside his Office was sometimes almost down the street there were so many patients. They called him DOCTOR FEEL GOOD, he was also convicted. Again why does it take so long and how can they add up MILLIONS AND MILLIONS of Dollars and NO ONE notices.

  • Paul Lucas

    Geezus H greed knows no bounds

  • LFOldTimer

    Medical insurance fraud is a widespread industry. If authoritays really wanted to they could pick off these operations like shooting ducks in a pond. But they seem to be very selective over who they target. Gee. I wonder why? 😉

    The real corruption happens in congress. How do you think Obamacare was approved without anybody in congress reading it? ha. This is the way it worked: Big money in pharma, insurance, medical devices, hospitals, AMA, etc…paid off the politicians who turned over their pens to big business and told them to go ahead and write the Bill – and congress would rubber stamp it. Very simple. You can research for yourself the very sharp rise in political donations from the medical industry to Obama and congress 2-3 years before Obamacare was kicked across the finish line. lol. And how did it all turn out? Well, as we all know Obamacare is on life support. The money is running out. And Trump is in a panic to do something before it all collapses. HUGE healthcare corps are pulling out of Obamacare in several states and the cancer is spreading. Some states are now left with little competition – which means healthcare costs SOAR and the quality of medicine deteriorates.

    I hate to say “I told ya so” but I did over and over and over again leading up to the passage of the ACA. I warned everybody. But who am I? Just another voice in the wilderness.

    If I were Trump I would turn a blind eye and just let it all collapse – then point the finger at Obama and the congressional dummycrats who approved the monstrosity. Yep. That’s what I would do. Why? Because we have passed the point of no return on healthcare. The system is so screwed up now that any which way they turn will be a failure. Let it collapse then build it back up again piece by piece. That’s our only hope. When I was a kid healthcare was great because it was largely governed by the ‘free market’. People generally paid for their routine day-to-day health care needs and were covered in the event of a serious illness. Routine health care at that time was reasonable. Most everyone (even the lower-middle class) could afford it. But the dirty politicians got the dirty idea of artiifically inflating medical costs to reward their sugar daddies in the healthcare industry – and the rest is history. Now healthcare is bankrupting producers in our society, which was rare back in the day.

    Do you ever ask yourselves why you never see a price list in your doctor’s waiting room? ha. Or in the hospital? ha. Once I asked my doctor’s office manager how much a certain procedure would cost me and she looked at me like I had 2 head with only 1 eye in each head. She said “What does it matter. You have insurance, don’t you???” HA! That said it all.

    Hang on tight, folks. The ship is going down. I don’t exactly know when. But it’s going down. It’s already starting to list if you haven’t noticed.

    Good luck to all.

    • justanon

      What a load of crap.

      • verifiedsane

        diaper boy goes whaa whaa whaa…….

      • LFOldTimer

        What an intelligent and sophisticated response. lol.

        • justanon

          It’s at least accurate, unlike your comment which is just a bunch of hooey that you’ve pulled out of your *ss.

          You’ve just written a FACT-FREE screed, you exaggerate, misstate and twist the truth to fit your warped world view.

          Why is it that the ignorant feel so entitled to pontificate and spread their manure without ever having to prove and back-up their BS?

          I could spend my day meticulously disproving your BS line-by-line, but it’s not worth my time. The ignoramuses and crazy partisans like verifiedsane don’t care about facts and anyone with two-braincells to rub together already recognizes that you’re just a right-wing nut cake parroting whatever cr*p you’ve read on Infowars, Breitbart, Drudge, etc.

          • LFOldTimer

            Once again, you offer NOTHING of substance to support your statement. You CLAIM my analysis is wrong – with ZERO counterargument.

            Intelligent people read your comment and laughed. They know that I won and you lost the argument (by default). ha.

            Now go back to biting your tail. LOL!

          • justanon

            Sigh …

            LF Old Bigot LIE:

            ” How do you think Obamacare was approved without anybody in congress reading it? ”

            TRUTH:

            “FACT: The ACA had a historic number of hours of debate and amendments during Committee development of the legislations.

            The House process spanned three committees – Energy and Commerce, Ways and means, and Education and Labor – with dozens of hearings over many months.
            Specifically, the House held 79 bipartisan hearings and markups on the health reform bill over the period of an entire year.
            House members spent nearly 100 hours in hearings, heard from 181 witnesses from both sides of the aisle, considered 239 amendments (both Democratic and Republican), and accepted 121 amendments.

            FACT: The Senate held dozens of public meetings and hearings in both the Finance and HELP Committees and accepted hundreds of Republican amendments.

            The HELP Committee held 14 bipartisan roundtables, 13 bipartisan hearings, and 20 bipartisan walkthroughs on health reform.
            The HELP Committee considered nearly 300 amendments and accepted more than 160 Republican amendments.
            The Finance Committee held 17 roundtables, summits, and hearings on health reform. The Finance Committee also held 13 member meetings and walkthroughs and 38 meetings and negotiations for a total of 53 meetings on health reform. [Senate Finance Committee, 5/3/10]
            The Finance Committee held a seven-day markup of the bill, the longest Finance Committee markup in 22 years, resulting in a bipartisan 14-to-9 vote to approve the bill. [Senate Finance Committee, 5/3/10]
            The Finance Committee markup resulted in 41 amendments to revise the bill, including 18 by unanimous consent or without objection. [Senate Finance Committee, 10/13/09]

            FACT: The financing of the ACA’s coverage provisions was well known and debated.

            When the bill came to the floor, the Senate spent 25 consecutive days in session on health reform, the second longest consecutive session in history. In total, the Senate spent more than 160 hours considering the health reform legislation.

            The non-partisan Congressional Budget Office issued many reports on the Affordable Care Act’s financing, clearly showing that revenue would be raised by the personal responsibility provision, also known at the individual mandate or free-rider penalty, in every case that it described the law’s coverage provisions. [CBO, 12/10; The Washington Post, 9/24/14; ASPE, 9/24/14]
            CBO also wrote extensively about how a properly-functioning insurance market would work as designed under the ACA. The entire purpose of insurance is to balance out the risk of healthy and non-healthy enrollees; anyone who believes that this point was avoided during debate of the ACA was simply not paying attention to advocates of the law as they described it during the many public hearings the law received.

            https://www.dpcc.senate.gov/?id=328&p=issue

            LF Old Bigot LIE:

            “…Obamacare is on life support. The money is running out. ”

            TRUTH:

            “But the authors of the Affordable Care Act didn’t want the subsidies to become a drain on the Treasury and add to the deficits. So they included provisions designed to offset the cost of the subsidies.

            MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies.

            “The other source of revenue is a tax increase on the wealthiest Americans,” he says. “Those families with incomes above $250,000 a year will now have to pay more in Medicare payroll taxes.”

            Those provisions actually make the bill a net positive for the federal budget, according to the nonpartisan Congressional Budget Office. By the CBO’s accounting, Obamacare will produce a surplus. Gruber says the law will “actually lower the deficit by about $100 billion over the next decade and by $1 trillion in the decade after.”

            http://www.npr.org/sections/health-shots/2013/11/07/243584170/how-the-affordable-care-act-pays-for-insurance-subsidies

          • LFOldTimer

            UNFACT: “The ACA had a historic number of hours of debate and amendments during Committee development of the legislations.”

            FACT: How could anyone intelligently debate the Obamacare legislation when BY THEIR OWN WORDS they had no idea what the bill contained – since even the House majority leader ADMITTED she did NOT know what was in ACA??? lol

            Failed response #1.

            UNFACT: “FACT: The Senate held dozens of public meetings and hearings in both the
            Finance and HELP Committees and accepted hundreds of Republican
            amendments.”

            FACT: Obamacare needed 60 votes in the Senate to pass. 58 Dummycrats voted for it. 2 Independents voted for it. 58+2 = 60.

            ZERO Senate Republicans voted for it. So those “hundreds of Republican amendments didn’t mean squat. Did they??? HA!

            Obamacare passed without ONE vote in congress!!!

            Obamacare is TOTALLY on the Dummycrats!!! HEALTH WITH IT

            Failed response #2.

            UNFACT: “The financing of the ACA’s coverage provisions was well known and debated”

            Obama and the Dummycrats openly LIED about Obamacare. They told us the average family would save $2500 while premiums and deductibles SOARED by thousands of dollars!!! lol Obama told us on the George Stepanopolous Show that Obamacare was NOT a tax. Then after it was approved in congress Obama’s lawyers argued before the SCOTUS that Obamacare WAS a tax and that’s the reason it was constitutional legislation!!! HA! He LIED through his teeth. And naturally we all remember the LIES “If you like your doctor you can keep your doctor” and “If you like your health plan you can keep your health plan”. LOL.

            Failed response #3.

            By covering for these LIARS you are no better than they are!!!!

            Truth from Jonathon Gruber??? A dyed in the wool liberal from MIT??? HA!

            The House Ways and Means Committee have come to the following conclusion on Obamacare:

            “Since the Obamacare exchanges opened for business on October 1, 2013,
            they have struggled to deliver quality, affordable health
            insurance options to Americans”.

            https://waysandmeans.house.gov/three-years-obamacare-exchanges-near-collapse/

            You are one of the fools who still claims Obamacare is a viable and effective health care system. You are a dinosaur who believes in fairy tales. Had you been a German in WW2 you probably would have been one of those who claimed Germany was winning the war while Russian troops were advancing on Berlin!!! HA!

            Thank you for all the comedy you give us. Keep coming back!!!!! LOL!

          • justanon

            ” the House majority leader ADMITTED she did NOT know what was in ACA???”

            This is your right-wing idiocy in a nutshell.

            You latch on to one out of context quote and somehow that negates the DOCUMENTED FACT that the ACA was debated for over a year, had multiple hearings and amendments, was scored by the CBO and the full text was publicly available on congress.gov as it moved along just like any other bill.

            The demonization of the ACA and all things Obama by the right-wing media worked because chumps like you ate up every negative word and wholeheartedly believed the BS.

            Another logic fail by you, just because no Republican voted for the ACA does NOT mean there was no outreach by the Democrats. The entire premise of the ACA was based on a Heritage Foundation plan, but because the Republicans decided on the night of Obama’s inauguration to OPPOSE EVERYTHING Obama and the Democrats proposed, the reality is that they were NEVER going to vote for ANY Obama/Democratic bill. And this was their plan even though the country was in crisis, how ‘patriotic’ was that?

            Proof of right-wing, nasty, lying, childish partisanship is your little cheesy nicknames like “dummycrats” you’re too blinded by hatred to even discuss legislation honestly and like an adult.

            In short, you and your right-wing brethren would BELIEVE AND SUPPORT ANYTHING as long as it’s anti-democrat, even if it means 20 million people lose their healthcare. I have no respect for you, you are just evil and stupid.

          • LFOldTimer

            Are you getting enough oxygen?

            1. In 2016 28 states saw over a double digit increase in PREMIUMS – deductibles soared as well.

            17 of those states saw more than a 20% increase in premiums.

            4 saw increases more than 30%!!!

            Obamacare is FAILING financially. The LARGEST health care plans (Aetna, United Health Care, etc..) are pulling out of states that reduces competition which forces prices UP and quality of health care DOWN!

            STOP YOUR SPIN!!! YOU HAVE LOST ALL CREDIBILITY ON THIS BOARD!!!

            https://freedompartners.org/latest-news/2016-obamacare-premium-increases/

            2. The dummycrats OWN Obamacare. Not a single Republican in CONgress voted for it because they saw the writing on the wall. And now their fears are coming to fruition!!! The proof is in the pudding!!! Obamacare would eventually BANKRUPT the nation if nothing is done.

            I recommend Trump to do NOTHING!!! Let it collapse then point the finger at OBAMA, the mastermind who orchestrated the BIGGEST failure in US history!!! Then build the health care system up piece by piece. This way the GOP will keep the majorities in the House, Senate and be guaranteed the White House for decades to come!!!

            THERE IS A REASON THE GOP CAPTURED THE HOUSE, THE SENATE AND THE WHITE HOUSE!!!

            UNTIL YOU COME TO GRIPS WITH REALITY YOU DUMMYCRATS WILL ALWAYS BE LOSERS!!! LOL!!!

          • justanon

            Of course, you just ignore all the facts. Yes, premiums are continuing to rise, but at a SLOWER rate than if the ACA had never passed. And how is 20 MILLION MORE PEOPLE WITH HEALTH INSURANCE A FAILURE???

            You “recommend” trump do nothing BECAUSE you are EVIL, 20 MILLION people losing their health insurance is a partisan game to you. That is EVIL, people WILL DIE!

          • LFOldTimer

            People are dying NOW from Obamacare. For the first time in DECADES the average American’s lifespan has DECREASED rather than increased. People are living SHORTER lives due to Obamacare. But you’re proud of that, aren’t you??? lol.

            The number of lives covered is not the primary goal of healthcare. The primary goal is to make sure it is sustainable FINANCIALLY so it doesn’t bankrupt the nation. What good is 20M more people with health care if 5 years down the road the health care system goes BANKRUPT and 150M are without health care?

            But Dummycrats always look through rose-colored glasses until we collide into a brick wall – then they ALWAYS blame other people for their own screw-ups. hah.

            That’s the reason they lost the majorities in the HOUSE, the SENATE and Trump won the WHITE HOUSE!!!! hah.

            Denial is like a disease. Oftentimes the host remains in denial until the disease spreads and overcomes major organ function. By the time the host awakes to reality – it’s too late and the disease wins the battle.

            Snap out of it.

          • justanon

            “The number of lives covered is not the primary goal of healthcare”

            Ha, ha, ha!!! Well, that’s about the DUMBEST comment you’ve ever made! Yes, the number of people who have health care IS THE PRIMARY GOAL!!! WHAT ELSE IS THERE????

            How is having millions of more Americans with health care HURTING life expectancy????? Show the math!!!

            The ACA is not responsible for decline in American lifespans, lack of HEALTH INSURANCE WAS AND IS (Republican governors not expanding Medicaid in their states) and hopefully with more people being covered and having access to health care those numbers will change for the better. Unless of course, we get trumpcare which is health care for the rich and healthy only and is the TOTAL OPPOSITE OF WHAT TRUMP PROMISED!

            Face it, trump LIED his way into office, he’s too stupid to understand healthcare and now we’re all going to be screwed because ignorant, hateful, bigots like yourself voted for that con-man!

          • LFOldTimer

            What good is having more people covered when it bankrupts the system and over 100M end up without medical coverage?

            Again, you don’t make any sense whatsoever.

            The quality of medical care suffered after Obamacare was approved. The American lifespan was not negatively impacted until Obamacare was in effect for about 2-3 years. First time since the Great Depression. So don’t take the low road and blame Bush. The US lifespan suffered as a DIRECT result of Obamacare. As a dummycrat take responsibility!!! 😉

            The Nobel Peace Prize winner Obama was one of the most violent President’s in US history. He dropped 100’s of thousands of bombs on nations we had NO LEGAL AUTHORIZATION to infiltrate and killed 100’s of thousands of innocent brown people. Repulsive!!! And you supported him!!! lol. If Obama was Pinocchio his nose would have touched the moon!!! lol. And you voted for him!!! lol.

            Why do you live in America if you are so anti-American with your pro-illegal alien opinions? Why don’t you go live in Guadalajara. I bet you’d be much happier there!!! 🙂

          • justanon

            The ACA is not going bankrupt, it taxed the wealthy and had mandates that pay for it. Yes, it needs to be fixed, but it still has provided coverage for 20 million more Americans!

            “The quality of medical care suffered after Obamacare was approved. ”

            WHERE ARE YOU GETTING THIS MISINFORMATION????

            Pull your head out of the right-wing slimesphere and join reality. The ACA IMPROVED healthcare coverage and QUALITY by ANY measure!

            “The American lifespan was not negatively impacted until Obamacare was in effect for about 2-3 years.”

            WHERE IS THE CAUSE AND EFFECT CONNECTION???? Just because two things happen at the same time does not mean they are connected. I guess that’s why you moron types disrespect science and education ‘cuz it gets in the way of your BULLSH*T!!!

            And look who supports the NEW BOMB DROPPER, YOU DO… HYPOCRITE, HA, HA, HA!!!

            You have a lot of nerve telling someone to go live somewhere else, must mean you’re DESPERATELY trying to change the subject because YOU ARE LOSING THE ARGUMENT!!!
            So sad when that happens, lol!!!!

          • LFOldTimer

            Obviously you’re living in La-La land and are beyond redemption. Nothing sticks with you.

            Aetna and United Healthcare (two of the largest health care providers in the USA) have EXITED Obamacare in several states and large medical markets. If they continued they’d go BANKRUPT.

            The middle-class producer can no longer afford the premiums and the deductibles charged by Obamacare. It like not even having insurance since all their medical costs are being paid out of pocket.

            So it’s NOT the wealthy who are hurting. It the MIDDLE-CLASS PRODUCER who is taking it in the short!!!! The wealthy will ALWAYS have health care coverage.

            Why won’t that land between your ears and stick?

            It futile to try and have a rational discussion with you. So I opt out. Go back to biting your tail. I choose to ignore you. 🙂

            What else happened in the last 2-3 years that causes the average life expectancy to drop for the FIRST time in many decades??? Medical care is the #1 factor in how long people live. 2-3 years AFTER Obamacare was approved the life expectancy began to DROP!!! If you can’t connect those dots I can’t help you, dearie!

          • justanon

            “Opting out” again??? You lose!!!

            I only post such silly cr*p because ‘winning’ these arguments is very important to you. Why? Why not try and LEARN something and open up your very brainwashed mind instead?

            I never said the wealthy were hurting, but rather that by getting rid of the ACA they are going to get a huge tax cut. That is an undeniable FACT.

            Sigh, no wonder you folks hate science so much because you obviously don’t understand how it works. I’ll say it again, just because two things happen at the same time does not mean they are connected … you have to PROVE cause and effect. So PROVE that more people having health insurance has caused a shorter life expectancy. Again, it has to be PROVED with data, not your partisan nutty bullsh*t.

            I also have never denied that health care in this country is outrageously expensive, but costs were rising faster before the ACA and the only REAL solution is single-payer. We know what you don’t want in health care, why don’t you tell us your solution?

            I want a government option added to the ACA exchanges or Medicare for all. What do you want?

            Or are you just into simplistic palaver like trump with no real understanding of the issues?

            “The plan gets better and better and better, and it’s gotten really, really good. And a lot of people are liking it a lot. We have a good chance of getting it soon, I’d like to say next week, but it will be — I believe we will get it, and whether it’s next week or shortly thereafter.”

            Ha, ha, ha that quote sounds like it should have come from a SNL skit, but sadly it’s a verbatim quote from trump on his health care plan just last week.

            # sad and embarrassing, lol!

          • Mic Bart

            I assume you will never sign up for Medicare? You know that government run healthcare plan that covers millions of seniors.

          • LFOldTimer

            Let me confide a little secret with you. Give me your ear…..

            Psst…. Medicare is for all intent and purposes bankrupt. It is unsustainable. If you’ve done your research you would already know this and I wouldn’t have to tell you. If you are under 50 years of age you will never use Medicare. You are paying for it. But you won’t benefit from it. By the time you reach 65 it will be no more.

            Mark my words. If you’ve read the financial report and added 2+2 you would know this. Sorry to be your messenger.

          • justanon

            I just read about 10 different articles on the 2015 drop in US life expectancy and funny thing, NONE of them listed the ACA as a reason. So again, I have to wonder which right-wing fever swamp you’re pulling your ‘information’ from???

            https://www.scientificamerican.com/article/whats-pushing-down-u-s-life-expectancy/

            Scientific American, are you going to label it “fake news” too, ha, ha, ha!

          • Mic Bart

            Of course it is not the ACA. That is ridiculous. The ACA is a healthcare plan just like any other insurance plan. Are deaths from car accidents related to their insurance plans or lack of insurance plans? Of course not!

          • Mic Bart

            What does any of this have to do with healthcare fraud? Ok we get it-you hate the ACA. The house passed the new healthcare bill (Trump bill) without reading it and the Senate has not passed it for fear of losing their jobs. We are waiting for the fantastic replacement that will according to Trump be much cheaper, much better and include all doctors. We are waiting.

    • Mic Bart

      The ACA is just one type of insurance plan. Fraud exists in All insurance plans whether they are government run or commercial. Do you actually believe that providers who commit fraud only pick on certain plans? The answer is NO. And you have to be naive to believe that fraud started with the ACA. Fraud is hard to detect when you think about the millions of claims submitted to companies like Anthem, Medicare and any other insurance payer. Consumers of healthcare need to demand transparent pricing, take ownership in what care they receive and more work needs to be done to examine claims and weed out providers who commit fraud. And we need severe penalties to deter others.

  • verifiedsane

    These workers comp scams have been running out of control for decades with the State Insurance Commissioner Dave Jones and county District Attorney Tony Rackauckas looking the other way & doing absolutely nothing…this is purely political deflection to mask the huge criminal corruption that is ongoing throughout workers comp by the insurance industry and political animals who are profiteering upon the broken backs and suffering of injured workers in California.

    This is more of the same old shell game of disseminating PR propaganda by the institutionalized power brokers to make sure the eyes of the public don’t look at where the real crimes and corruption that are being perpetrated; those would include the governors office, the legislature, chamber of commerce & insurance industry lobbyist, and a purposefully dysfunctional WC system rot with political nepotism, cronyism, bribery, and injustice.

    • #Respect

      I can totally relate being that I was injured at work recently. The whole work comp system seems like a big scam with profits above patient care. The doctors and insurance companies are in cahoots. I just want to get well so I can get back to the job I enjoy. It’s been a terrible journey that I wouldn’t wish on anyone.

      • LFOldTimer

        “The doctors and insurance companies are in cahoots.”

        Of course they are. Think about it:

        Why else would there be no price lists for procedures in the doctor offices or hospitals?

        And why else would you NOT find out what your visit to the doctor’s office or hospital would cost you until at least a month after the services were rendered?

        Let’s say you walked into a big box store and no items were priced. And when you walked to the the check-out counter the clerk told you: “I can’t show you how much you owe right now. Pay for your items today and we’ll send you a bill in a month. That’s the way our system works”.

        How would you react? Naturally you would leave your cart in the store and refuse to do business with such an organization.

        Yet you are FORCED to deal with the medical system that specializes in concealment and price-gouging. They treat you just like the fictitious big box store that I described above. They got ya by the short hairs.

        Why? Because the politicians who make the laws are bribed by the medical industry to vote for laws that benefit the corporations as opposed to the citizen consumers.

        This is not hard to understand. Only those in denial refuse to acknowledge and accept THE FACTS.

        Justanon – you out there??? LOL!

        • justanon

          I thought you right-wingers loved the “free-market” and “privatization”?

          You should be giddy that insurance companies are making money off the sick. After all isn’t one of the right-wing’s favorite mantra’s is “get the government out of healthcare”? Aren’t you supporting the right of insurance companies to offer sh*tty insurance plans that don’t cover anything and to gouge consumers because that’s exactly what they were doing prior to the ACA.

          And isn’t that exactly what your man trump is doing, corporatizing America and institutionalizing “pay-for-play”? I hear that they don’t even bother taking the corporate letterhead off of the legislation they’re allowing the corporate lobbyists to write.

          Ha, ha, ha, you maroons were suckered, you jumped from the frying pan directly into the fire!

          • LFOldTimer

            It’s the Dummycrats who made out like bandits on Obamacare.’

            Obama collected MULTI-MILLIONS of donation dollars from big pharma and the medical industry for pushing Obamacare that was AUTHORED by the health care corporations and rubber stamped by the DUMMYCRATS, without a single GOP vote!!!! HA!

            Go research the political campaign donations from the medical industry to the DUMMYCRATS leading up to the passage of Obamacare!!!! They all played ball with the FAT CATS in health care!!! LOL!!! They played ball while BANKRUPTING the nation as Nancy “the collectivist” Pelosi gave her vote of approval WITHOUT EVEN KNOWING WHAT THE ACA BILL CONTAINED!!!!

            And OBAMA LIED like a used car salesman to push his legislation across the finish line. I’ve already DOCUMENTED his lies that you FAILED to address!!!

            Now go fill up your water bucket and buy another shoe shine kit to polish the DUMMYCRAT’S shoes!!! You’ve run out of polish!!!!

            HAH!!!!

          • justanon

            You’ve “documented” nothing.

            1) But whose getting the most money NOW????? Yet, YOU still supported the Republicans …. HYPOCRITE!!!! LOL!

            “… During the 2014 cycle, Republicans received 58 percent of industry contributions whereas Democrats received only 42 percent.”

            https://www.opensecrets.org/industries/indus.php?ind=H04

            2) Pelosi knew what was in the bill, but do continue to CHILDISHLY CLING to your right-wing smear DESPITE the FACTS!

            3) The ACA is funded by the mandate requiring people to buy health insurance plus a slew of taxes, so IT IS FUNDED.

            “The CBO now says that the program, which critics deride as an insurance “bailout,” will earn the government $8 billion over the 2015 to 2017 period. Last May, the CBO said that the program had not net budgetary effect.

            The government will pay insurers $8 billion over the period but will collect $16 billion in return from companies, yielding a net benefit.
            The fact the program helps the budget could make GOP arguments against it more difficult and could require the party to find an offset in any bill repealing it. ”

            http://thehill.com/policy/finance/197367-cbo-now-says-obamacare-risk-corridors-help-deficit

            4) YOU are a huge HYPOCRITE!!! If you think Obama’s lie was sooo huge, what about trump’s?????

            “We’re going to have insurance for everybody,” Trump said in press conference Jan. 11. “We’re going to have a healthcare that is far less expensive and far better.”

            THAT IS THE BIGGEST CROCK O’ SH*T EVER!!!!!!!

            Address trump’s MASSIVE LIE, I DARE YOU!!!

          • LFOldTimer

            1) How could you judge the GOP reform plan? It hasn’t even been finalized or implemented. Again, you’re talking out your hind end (as usual). hah.

            You know Obama and the dummycrats PERSONALLY made out like bandits by taking bribes from big business (pharma, devices, insurance, etc…) from 2008 to 2010 while Obamacare was on the table. You just refuse to admit it because you are dummycrat shoe shiner!!!! hah.

            2) Oh yeah. Nancy Pelosi knew what was in Obamacare – that’s the reason she told the world during the vote: “We have to pass it to find out what’s in it”. So now are you calling her a liar??? hah. You are in such denial. Snap out of it. 🙂

            3) If Obamacare was funded the BIGGEST health care plans (Aetna, United Health Care, etc…) wouldn’t be WITHDRAWING from it, you fool!!!!

            Why would you believe the CBO. The CBO analysis of Obamacare prior to approval was TOTALLY flawed and misrepresented what actually ensued in the next 4 years. IOW’s the CBO are nothing but a group of paid off incompetent political hacks who couldn’t predict where the sun will rise tomorrow morning!!! hah. And fools like you still believe them!!! lol.

            4) Trump hasn’t lied because there is NO replacement for Obamacare. How can you lie about something that hasn’t even been implemented?

            We KNOW Obama lied about Obamacare to sell it to the American people. All the LIES are documented. Your thinking is SO RIGID and in such DENIAL that you refuse to accept the FACTS!!!

            HAH! I suggest you stop posting. You’re making a fool of yourself.

          • justanon

            1) Just saying people took bribes doesn’t make it so. Prove that allegation.

            2) Again, with the Pelosi quote out of context. Do you NOT believe that the ACA was debated for over a year and that there were dozens of hearings, testimonies, amendments and CBO scorings??? Only PARTISAN HACKS and Breitbart/Fox followers believe that congress didn’t know what was in the bill. You aren’t very bright so you’re easily led astray by dumb cr*p and believe me, your ‘news’ sources know that. That is how they CON you out of voting in your self interest instead of the billionaires interests. Repealing the ACA is a HUGE TAX CUT for the WEALTHY, chump.

            3) Look no further than the Republican party for the failure of enough young people signing up for the ACA. That’s what happens when you continually run down a program for years. A friend of mine resisted “Obamacare” for two years, finally looked into it this year and is SAVING over $2,000!!! Surprise, surprise … not!
            But I’d be fine with scrapping those effing insurance companies, why should they make a profit off of basic healthcare? Bring on single payer!!!

            4) Well, we saw his last HORRIBLE PLAN and this one is rumored to be even worse! And one thing WE KNOW FOR SURE is that it’s NOT going to be “cheaper”, “better” and “cover everyone”!
            Only a chump and a FOOL would believe that, lol!!!!

          • LFOldTimer

            “1) Just saying people took bribes doesn’t make it so. Prove that allegation.”

            Do you think it was just a coincidence that they took the bribes (political donations) and voted ‘yea’ on Obamacare? Don’t be naive. If not for Obamacare the medical industry would’ve NEVER made those ‘donations’.

            Obama made millions in “donations” from the medical industry. Go do your research.

            Just like after Hillary lost the election. All the sudden the “donations” to the Clinton Foundation Fund dropped by 90%!!!! HAH!

            “2) Again, with the Pelosi quote out of context.”

            Hogwash. She was asked a simple question about how it was possible to read and digest over 2000 pages of Obama legislation in such a short time. To that she answered: “Sometimes you have to pass a bill to find out what’s in it”. Not taken out of “context”. Stop it!!!

            Nancy needs a shoeshine. Got some free time??? lol.

            “3) Look no further than the Republican party for the failure of enough young people signing up for the ACA.”

            More nonsense. Young people refused to show up because most are extremely healthy and don’t have $200 a month to throw down the rathole. Everyone predicted this prior to the Obamacare approval. Only a FOOL would’ve believed differently.

            People are NOT going to be forced to buy something they don’t need!!!!

            “4) Well, we saw his last HORRIBLE PLAN and this one is rumored to be even worse!”

            No Republican plan is even on the table, so how could you possibly judge something that doesn’t even EXIST!!!! hah.

            You make stuff up then expect other people to buy into it. Intelligent people would laugh at your comments. But keep the comments coming! The comedy is second to none!!!! 🙂

          • justanon

            1) Again no proof, just right-wing mudslinging, so FAIL!

            2) ““You’ve heard about the controversies, the process about the bill…but I don’t know if you’ve heard that it is legislation for the future – not just about health care for America, but about a healthier America,” she told the National Association of Counties annual legislative conference, which has drawn about 2,000 local officials to Washington. “But we have to pass the bill so that you can find out what is in it – away from the fog of the controversy.””

            An easy quote to misconstrue, but it still doesn’t change the FACT that the legislation was debated for over a year, had multiple hearings and amendments and was scored by the CBO. So you can dwell on that statement and whip up your faux outrage, it still doesn’t alter the TRUTH and that is that congress KNEW what was in the bill!

            4) I guess your right-wing ‘news’ sites don’t keep you too informed, lol. But the rest of us have been reading about the different ‘options’ the Republicans are debating and NONE of them are good for average people. So you can ‘pretend’ that a miracle is going to happen and trump is going to deliver on his “better, cheaper, coverage for all”, but those of us in the REAL WORLD know it’s going to be one big SH*T sandwich that the GOP will be trying to force down our throats and all to give the 1% a huge tax cut!!!

            You might want to get CHUMP tattooed on your forehead, just as a reminder because YOU’VE BEEN CONNED!!! LOL!!!

          • LFOldTimer

            I’ve taken you to the woodshed so many times on this topic that the hinges on the woodshed door are worn out. Intelligent readers could easily see the flaws and lack of rational thought in your comments. So I choose to end this discussion.

            Please pick up all the manure that fell from the wall to the floor before you leave the room.

            Better luck next time.

          • justanon

            Yeah, you’re a real ‘legend’ in your own mind, lol.

            There’s a film called “The Brain Washing of My Dad”, it’s about old, white codgers who’ve steeped themselves in right-wing hate radio and Fox ‘news’ and how it makes them bitter, hateful and MISINFORMED. That’s you.

            You’re actually kind of pathetic in your ignorance, but when that ignorance is coupled with hatefulness and a disregard for other peoples lives it becomes evil.

            You are a sad, vile, ignorant and brainwashed old man, you should restrict yourself to yelling at the TV instead of embarrassing yourself here everyday.

          • verifiedsane

            justanon the namby–pamby diaper boy continues throwing childish tantrums…Whaa Whaa Whaa……just more tired & pointless droning on, with a never ending drivel of unhinged feckless personal attacks that are void of any substantive value spewing from this anti-American anarchist provocateur.