Santa Ana, CA (WorkersCompensation.com) – A California physician/ambulatory surgery center owner and his girlfriend have been charged in a $600 million billing fraud scheme that could result in as much as 84 years of prison time if found guilty.
Dr. Randy Rosen, an Anesthesiologist specializing in pain management and the primary owner of Wellness Wave surgery center, pled not guilty to 88 felony charges brought against him in two cases. This is the second time Rosen has been in trouble for alleged fraudulent activity. Federal law enforcement officers in Orange County allege Rosen targeted those recovering from drug and alcohol addiction for the purpose of fraudulently billing insurance for medically unnecessary surgical procedures involving implantation of Naltrexone for addiction treatment. Naltrexone works to block the effects of opioids by occupying opioid receptors, having an antagonistic affect. Approximately $600 million was billed for these procedures resulting in insurance payments totaling around $50 million, officials allege.
Rosen has been charged with 8 counts each of creating false insurance documents, fraudulent billing of insurance, withholding material facts, conspiracy to commit unlawful patient referrals, and 16 counts of money laundering. Due the amounts involved in the case, Rosen was also charged with white collar crime.
With regard to the separate case for the alleged workers’ compensation scheme, Rosen has been charged with 24 counts of withholding material facts for insurance, and 17 counts of creating false documents for billing insurance. Additionally, he was charged with crime-bail-crime enhancement due to committing a crime while out on bail from a previous workers’ compensation insurance fraud case from 2013.
Rosen’s girlfriend, Liza Vismanos has been implicated in the scheme as well. Vismanos, also the president of the Wellness Wave surgery center, pled not guilty to 56 felony charges in both cases.
Rosen is accused of requiring his implant patients to undergo allegedly unnecessary drug testing that was done at Lotus Laboratories, which is also owned by Vismanos. Vismanos allegedly billed over $3 million to more than 22 different insurance companies as a result.
Vismanos has been charged with 8 counts each of creating false insurance claims, fraudulent billing of insurance claims, withholding material facts for insurance, and conspiracy to create unlawful patient referrals. Like Rosen, Vismanos was also charged with white collar crime. On the workers’ compensation case, Vismanos was charged with 24 counts of withholding material facts for insurance.
In the workers’ compensation case, both parties were charged with aggravated white collar crime enhancement.