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5 to plead guilty to health care fraud charges

On Nov. 24, federal prosecutors in California announced that five people had been charged for participating in a $600 million health care kickback scheme. One of the accused individuals formerly worked as the chief financial officer for a hospital in California. Among the five accused people, two have already pleaded guilty, and three are expected to plead guilty.

A spokesman for the U.S. Attorney said that all five of the accused people are cooperating with a large-scale federal investigation into health care fraud. The investigation has been named 'Operation Spinal Cap" due to the alleged fraudulent spinal surgery billings that are being investigated. According to prosecutors, the accused people engaged in a scheme that involved thousands of fraudulent spinal surgery claims from Pacific Hospital in Long Beach.

The former owner of the Long Beach hospital has already pleaded guilty for his role in the scheme, and a California state senator was indicted for accepting $100,000 in bribes from the hospital owner. Prosecutors say that the senator accepted bribes in exchange for his agreement to help preserve a legal loophole that was allowing the hospital owner to make more money from spinal surgeries.

People who have been accused of taking part in a health care fraud scheme may argue that they had no knowledge of the alleged scheme. An attorney may be able to help a person in this situation to build a defense against the charges by gathering evidence to prove that they were not directly connected to illegal activities. If the prosecution's evidence is strong, however, the attorney might recommend that the defendant plead guilty to a lesser charge and agree to cooperate with the authorities in exchange for a reduced penalty.

Source: Reuters, "Five charged in $600 million California health care fraud scheme," Dan Whitcomb, Nov. 24, 2015

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