$40 million billing scheme results in charges for 26 doctors, pharmacists

California prosecutors charged 26 physicians, pharmacists and business owners in an alleged billing fraud and kickback scheme that collected more than $40 million from insurers by prescribing unnecessary medications or balms which had no medical value.

According to the California Department of Insurance and the office of the Orange County District Attorney, Tanya Moreland King and her husband, Christopher King, “masterminded” the scheme through their Beverly Hills-based medical billing companies, Monarch Medical Group, King Medical Management and One Source Laboratories. They’re accused of recruiting physicians and pharmacists to order medications and tests to workers’ compensation insurance patients which they didn’t need, with the prescribers then masking the kickbacks as “marketing expenses.”

“The Kings and their co-conspirators played with patients' lives, buying and selling them for profit without regard to patient safety," said Dave Jones, California’s insurance commissioner. “Patients have the right to expect treatment decisions by health care professionals are based on medical need and not unadulterated greed. The magnitude of this alleged crime is an affront to ethical medical professionals.”

Among their alleged co-conspirators were registered pharmacists Charles Bonner and Mervyn Miller, co-owners of Steven's Pharmacy in Irvine, California. They allegedly prescribed more than $1 million worth of “compound creams” that haven’t been approved by the Food and Drug Administration and have no proven medical benefits.

Investigators said the Kings bought the creams for between $15 and $40 each, but billed insurers for up to $700 per prescription.

Other elements of the alleged scheme included paying doctors to order unnecessary urine tests, and then billing insurers hundreds of dollars more than what the test actually cost.

According to prosecutors, more than 13,000 patients and 27 insurance companies were affected between 2011 and 2015.

“The intent of many of the laws surrounding the insurance industry is to keep the three Ps—physician, patients and profit—separate. We have a track record of putting these types of fraudsters behind bars for a long time and we intend to do just that again," said Orange County District Attorney Tony Rackauckas.