Insurance Fraud NEWS
UPS worker recruits cronies for false sleep studies in California
April 22, 2019, Torrance, CA
A Torrance man who worked for United Parcel Service was sentenced Monday to two-and-a-half years in federal prison for his role in a fraud scheme that billed employee health coverage providers for unnecessary -- and sometimes never-performed -- sleep studies.
Eddie Hernandez, 45, pleaded guilty in November in Los Angeles federal court to one count of healthcare fraud, according to the U.S. Attorney's Office.
Prosecutors said Hernandez and co-defendant Anna Vishnevsky, 51 -- owner of a Studio City sleep diagnostics clinic -- helped recruit so-called patients by offering cash in exchange for participating in sleep study testing.
They also offered additional cash to those who brought dependents and referred co-workers to participate in the scheme.
The defendants recruited patients knowing that no doctor had prescribed sleep study testing for them, and regardless of whether the testing was medically necessary, prosecutors said.
Vishnevsky -- who also pleaded guilty to one count of healthcare fraud and is expected to be sentenced May 9 -- failed to score or interpret the data from the testing, or provide it to anyone who could score or interpret it, which is necessary for diagnosis and treatment, according to prosecutors.
Investigators believe that Hernandez and Vishnevsky helped submit more than $11 million in fraudulent claims, most of which related to beneficiaries of the UPS and Costco health care benefit programs.
Source: NBC Los Angeles