Med-Cal Fraud for billing device other than one used

Dec 19, 2011

The Second Appellate District in California affirmed a judgment of conviction for a physician who committed fraud for knowingly billing Medi-Cal for use of an expensive and approved medical device when he instead used a cheaper device that was not approved for reimbursement.

From 2004-2006, the office of OB-GYN Eduardo Guzman billed Medi-Cal for the insertion of 176 IUDs. The billings used the precedure code designated for teh trade name “ParaGard” when in fact he used a cheaper type of IUD manufactured in Mexico.

The court found the evidence at trial was sufficient to show an intent to defraud Medi-Cal.

The case is: People v. Guzman, ___C.A.2nd; Dec. 12, 2011; B232299.