Last week, 20 people were arrested in a California Medicaid fraud ring which raked in $4.6 million for nursing services given by people with no license to practice nursing in the U.S. Some of the defendants are being accused of organizing a scheme to hire out unlicensed nurses while others are being charged with posing as these licensed nurses.
According to the U.S. attorney for central California, the impostors put many lives at risk by attempting to provide home or school based care to disabled patients with a range of ailments from developmental disabilities to cerebral palsy, including many child patients. U.S. Attorney Thomas O'Brien further noted that it is the largest case of Medicaid fraud in California.
The 20 who have so far been arrested were charged with conspiracy to commit healthcare fraud and at least one count of healthcare fraud. Some of the charged unlicensed nurses have had foreign training but never passed a U.S. qualifying nursing exam to officially become RNs here. Others had no medical training whatsoever.
The accused ringleaders, Susan Bendigo and Priscilla Villabroza, told the workers to lie about their unlicensed status and then provided them with documents containing information for actual licensed nurses, according to the indictment.
The fraud was uncovered when patients and parents of patients began to suspect a lack of qualification in the supposed nurses. Their skill set was not what it should have been, which endangered many lives. The statement reported that one of these fraudulent nurses was unable to replace a tracheotomy tube when it fell out of a youngster's neck. Another unlicensed nurse became overwhelmed when she couldn't handle a medical situation and fled the scene.
Villabroza operated the home health agency, the Santa Fe Springs Company Medicare Plus Home Health Providers, and Bendigo was a director at the company. The indictment claims they knowingly provided unlicensed nurses to home health agencies, and further billed Medi-Cal for the work of licensed vocational nurses from August 2004 through 2007. Both women are registered nurses themselves.
The two are being tried separately. Villabroza pleaded guilty to five federal counts of healthcare fraud and Bendigo fled the country. Villabroza could be sentenced to up to 50 years in prison and each of the 42 new defendant is looking at a statutory maximum penalty of 10 years in federal prison for each charge, if convicted.