In a stark revelation of fraud within the healthcare system, a California physician has admitted to conning the Medi-Cal Family PACT program out of over $2.5 million. According to a press release from the Department of Justice, Dr. Robert Eyzaguirre, the 77-year-old owner of Dr. Robert's Medical Center in Bellflower, was the mastermind behind the multi-million dollar scheme targeting services intended for low-income and uninsured patients.
The deceit was designed to bilk the system through a web of false claims, a charade which Eyzaguirre admitted to orchestrating alongside accomplices Gary Lee Didio and Sandra Rios. From December 2013 to January 2020, they engineered over $4.6 million in bogus claims, to then quickly receive unjust profits. In an audacious attempt to conceal their actions, fake patient files were created and submitted for reimbursements for services never rendered. The Department of Justice report, has disclosed that Eyzaguirre would even preemptively sign blank patient forms, leaving them to be filled with falsified information at a later time.
Further unearthing the extent of this fraud, it was revealed that Eyzaguirre and his cohorts referred non-existent patients to a lab in Northern California, facilitating over $372,000 in illegal kickbacks. The ripple effect of their deceit caused the Medi-Cal program to pay out more than $1 million on fraudulent claims submitted by the laboratory as part of the scheme.
Upon realizing that law enforcement was closing in on the fraud, Eyzaguirre, whose actions already betrayed the trust placed upon him as a healthcare provider, attempted to further thwart justice. Court documents state that he tried to instruct Didio to secretly remove the falsified files from the clinic and destroy evidence. Despite these efforts, their house of cards inevitably collapsed, as all parties involved have now pleaded guilty to their participation in the fraud.
With justice now seeking to catch up, Eyzaguirre faces a statutory maximum sentence of 10 years in federal prison for health care fraud, while Didio and Rios await sentencing after pleading guilty to conspiring to receive illegal remunerations for healthcare referrals. The sentencing hearing for Eyzaguirre is set for October 28, according to the United States District Judge Jesus G. Bernal. The case was probed by the United States Department of Health and Human Services Office of Inspector General and the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse, with Assistant United States Attorney Jason C. Pang leading the prosecution efforts.
Public Information Officer Ciaran McEvoy of the U.S. Attorney's Office relayed these details on the official website, shedding light on the gravity of the situation and the ongoing efforts to uphold integrity within the healthcare system.
