Ex-Whittier Health Clinic CEO gets 10+ years in prison for scheme to defraud Medi-Cal - Insurance News | InsuranceNewsNet

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January 23, 2024 Newswires
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Ex-Whittier Health Clinic CEO gets 10+ years in prison for scheme to defraud Medi-Cal

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The former president and CEO of a Whittier medical clinic was sentenced today to 124 months in federal prison for submitting fraudulent billings to a Medi-Cal health care program that provides family planning services to low-income Californians who lack health insurance.

Vincenzo Rubino, 59, of Valencia, was sentenced by United States District Judge Otis D. Wright II, who also ordered him to pay $3,815,478 in restitution and entered a money judgment of $2,308,028.

Rubino pleaded guilty in August 2023 to nine counts of health care fraud and two counts of aggravated identity theft. Rubino pleaded guilty mid-trial when the prosecution had nearly finished presenting its case to the jury.

Rubino founded, owned and operated Santa Maria's Children and Family Center, a Whittier-based medical clinic based registered as a non-profit public benefit corporation and enrolled as a Family Planning, Access, Care and Treatment (Family PACT) provider run through Medi-Cal.

From November 2014 to August 2017, the center submitted fraudulent claims totaling nearly $5 million to the Family PACT program for family planning services that were never provided, often using the information of patients who were recruited at off-site locations with offers of free diabetes testing.

To submit many of these claims, Rubino used the names of two medical providers who were not employed at Santa Maria's. The patients did not see these providers - a physician's assistant and an elderly doctor who was himself a patient in a skilled nursing facility during much of the scheme.

The Medi-Cal program paid more than $2.3 million dollars on the fraudulent claims, as well as an additional approximately $1.5 million to a pharmacy and laboratory for claims stemming from referrals from Santa Maria based on the same services that were never delivered.

"This defendant took advantage of health-care services intended for people in need," said United States Attorney Martin Estrada. "Instead of allowing that money to go where it was intended, Rubino stole millions of dollars through sham claims to Medi-Cal for family planning services that either were unnecessary or unprovided. Today's sentence highlights my office's resolve to protect the most vulnerable in our community."

"Vulnerable families across California trusted Santa Maria's Children and Family Center to receive high quality care for their health," said California Attorney General Rob Bonta. "Yet, the defendant knowingly exploited patients and healthcare benefit programs for their personal gain. At the California Department of Justice, we remain committed to holding bad actors, like Vincenzo Rubino accountable for defrauding Californians and stealing from taxpayer-funded programs. I want to thank the U.S. Department of Justice for their partnership in this investigation."

The United States Department of Health and Human Services Office of Inspector General and the California Department of Justice investigated this matter.

Assistant United States Attorneys Kristen A. Williams of the Major Frauds Section and David H. Chao of the General Crimes Section prosecuted this case. Assistant United States Attorney Tara B. Vavere of the Asset Forfeiture and Recovery Section is handling the asset forfeiture portion of this case.

* * *

Original text here: https://www.justice.gov/usao-cdca/pr/former-ceo-whittier-health-clinic-sentenced-more-10-years-prison-running-multimillion

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