Feds Secure Plea Deals From Five Defendants in Kickback Cases
Tuesday, July 11, 2017 | 5018 | 0 | 59 min read
The California Division of Workers’ Compensation has more names to move from the list of indicted providers to the list of convicted providers as prosecutors in Southern California have quietly secured pleas from defendants accused of defrauding Medicare and federal workers’ compensation programs.
John Garbino, president of Trestles RX, pleaded guilty on June 26 to receiving illegal payments in exchange for referring people to seek compound drugs that were paid for by the federal Tricare program.
Also, between June 20 and July 3, the U.S. District Court for Central California also accepted four pleas by one physician and three marketers accused of accepting kickbacks for arranging compound drug prescriptions for people covered by Tricare, Medicare and the federal Office of Workers’ Compensation Programs.
Garbino pleaded guilty to receiving $926,563 in kickbacks for compound drug referrals. Trestles RX was the company named in the indictment and charging documents, and Trestles Pain Specialists was a separate company that handled workers’ compensation claims.
All documents relating to the plea agreement are under seal, according to the court’s website. The U.S. Attorney's Office in Los Angeles did not return phone calls from WorkCompCentral on Monday. But a docket entry notes that Garbino pleaded guilty to the only count against him in a criminal information and is scheduled to be sentenced Dec. 4.
Charges filed with the U.S. District Court for Central California in June 2016 allege Garbino and Trestles RX in 2015 contracted with the Trucare pharmacy in Corona to handle “overflow prescriptions” from Haeoyou Pharmacy in Palmdale.
An affidavit by FBI Special Agent Monica Pandis says the owner of Trucare, identified as “M.K.”, claimed the prescriptions referred to his pharmacy were the ones that Trestles “had referred to Haeoyou in exchange for a referral fee, but that Haeoyou lacked the ability to fill the prescriptions.”
The affidavit says the owner of Trucare became “suspicious” after noticing that all the prescriptions were for at least five different products. The owner reportedly said a purported co-owner of Trestles identified in court papers only as “D.F.” instructed Trucare to “fill prescriptions for just three of the products on the forms and that should not make them appear as suspicious.”
Although “D.F.” is not identified in any related court documents, David Wayne Fish told WorkCompCentral in April 2016 he had worked for Trestles. Fish was convicted of paying kickbacks in exchange for referral fees through Premier Medical Management Systems Inc. in 2010. He was convicted of capping and steering workers’ compensation patients in the 1990s, according to documents filed with the Workers’ Compensation Appeals Board.
Charges against Garbino were announced at the same time federal prosecutors announced charges against Dr. John Pal Singh Janda, Michael S. Sinel, Michael D. Roub and Gary D. Schoonover. The five were part of what federal prosecutors called the largest medical fraud bust in terms of total losses and number of defendants. The U.S. Attorney’s Office charged 301 people nationwide with generating more than $900 million in fraudulent billings.
Janda, Sinel, Roub and Schoonover all appeared in court last month for change of plea hearings. They initially pleaded not guilty during arraignments held in June 2016.
Docket entries for the change of plea hearings, like the plea agreements themselves, are not available to the public through the court’s website. As a result, it’s not clear whether the four pleaded guilty or no contest. With each defendant facing 20 separate counts, it’s also not clear to which of the charges they pleaded.
But text-only scheduling notices on the court’s website note Sinel’s change of plea hearing was held June 19 and that the new plea was accepted June 20.
Change of plea hearings were held on June 29 for Schoonover and Roub. One updated plea was accepted on June 29 and the other on July 3.
Janda’s plea change hearing was June 30 and his plea was accepted on July 3, according to court records.
Janda was accused in an indictment filed June 16 of participating in a scheme through which Valley View Pharmacy generated invoices for compound creams dispensed to patients covered by federal health care programs. He allegedly authorized the pre-printing of prescriptions for compound creams despite having never met the patients and without first considering a non-compound drug.
The indictment alleges Janda received $345,000 in kickbacks for prescriptions provided to at least 148 patients.
Sinel, Roub and Schoonover are accused of acting as “marketers” for Valley View Pharmacy and soliciting physicians to authorize prescriptions for compound drugs, and routing the prescriptions through Valley View rather than allowing the patients to fill them at the pharmacy of their choice.
Sinel and Roub together received $4.7 million in kickbacks between 2011 and 2015, according to the indictment. Schoonover allegedly received $250,000 in kickbacks over the same period.
Meanwhile, marketer Jonathan Pena, who was also indicted in June 2016, is scheduled to appear before a judge in the U.S. District Court for Southern California on Wednesday for a change of plea hearing. Again, the documents relating to the plea are not available to the public.
Pena is accused of marketing compound creams for New Age Pharmacy, owned by Hootan Melamed, by arranging kickbacks for physicians who prescribed the medications. It’s not clear from the indictment the total amount of kickbacks allegedly paid, but court papers say doctors participating in the scheme typically received $150 to $200 for each Flurbiprofen cream prescription, and $150 for each gabapentin cream prescription.
Garbino, Janda, Sinel, Roub, Schoonover and Pena are all on the Division of Workers’ Compensation’s list of criminally indicted physicians and providers whose liens are stayed pursuant to Senate Bill 1160. With the recent pleas, they could soon be moving to the list of physicians, practitioners and providers who have been issued a notice of suspension, and possibly join the 25 who have been kicked out of California’s workers’ compensation system for defrauding a federal health care program.