司法部洛杉矶医疗诈骗大清查：15人被起诉涉虚假申报逾18亿美元 含史上最大假戒毒康复案
美国司法部10月22日宣布，在洛杉矶地区医疗诈骗系列案件中起诉15名被告，其中包括6名医疗专业人员，涉案虚假申报总额超过18亿美元，申报对象包括政府与私人医疗保险计划。8名被告于当日被捕，其中6人预计当天下午在位于加州洛杉矶县洛杉矶市中心的联邦地区法院首次出庭，另2人在德州的联邦法院出庭。司法部表示，起诉书中的指控均为指控，被告在被法庭证明有罪之前推定无罪。
涉案金额最大的一起案件涉及超过16亿美元的虚假申报。检方指控，被告 David Young（71岁，又名「Sancho Lopez」）与 Nathan Young 控制了数十家所谓的戒毒康复治疗公司，父子二人伙同 Honey Phipps（42岁）与 Cody Phipps（36岁）等人，通过被称为「病人掮客」的招募者，从全美各地网罗无家可归者、贫困者等弱势人群，将其送往南加州等地的机构接受虚假或根本不存在的戒毒治疗，并向私人保险公司申报费用。司法部称，这是该部起诉过的规模最大的清醒之家（sober home）诈骗案。检方称，曾任区域经理的 Nicholas Moore 已认罪，承认协助提交了1.99亿美元的虚假申报。
第二起案件涉及向联邦医保（Medicare）虚假申报的1.34亿美元。检方指控，Anaheim 心胸外科医生 Harold Tabaie（78岁）与 Hany Malek 涉嫌为并不需要的病人实施动脉粥样硬化斑块切除手术，部分病人因此受伤。此外，三起安宁疗护（hospice）诈骗案合计虚假申报超过1.38亿美元，涉案病人并未病重临终；另有一名被告此前已被控以虚假处方药申报诈骗加州医疗补助计划 Medi-Cal 2.7亿美元，本次被正式起诉。
司法部全国诈骗执法司助理司法部长 Colin M. McDonald 表示：「这些指控包括本部起诉过的最大清醒之家诈骗案，以及一起通过数据分析发现的无谓侵入性手术案。」加州中区联邦检察官办公室第一助理联邦检察官 Bill Essayli 表示，医疗专业人员本应恪守不伤害病人的誓言，却因贪念犯罪，尤为恶劣；从公共与私人医疗保险系统中骗走的每一美元，都是真正需要的人少掉的一美元。
在动脉手术案的执法行动中，联邦调查局人员22日清晨包围了洛杉矶 Tarzana 一处豪宅，逮捕61岁的脊椎按摩师 Hany Malek。据纽约邮报报道，检方称 Malek 备有武器，被列为持械危险人物。检方指控，Malek 冒充医生，诊断病人患有并不存在的动脉疾病并建议手术，Tabaie 随后实施手术，包括对同一患者重复手术。
同批被起诉的还有 Walnut 的医生王德军（Dejun Wang，62岁）：检方指控他违规出售处方药样品，将包括 Rybelsus、Ozempic、Mounjaro 在内的样品药卖给 San Gabriel Valley 的药房经营者，后者重新包装后向顾客分发；处方药样品属推广用品、不得出售。
DOJ Charges 15 in Los Angeles Health Care Fraud Takedown Tied to Over $1.8 Billion in Alleged False Claims
The U.S. Department of Justice announced on October 22 that it had charged 15 defendants, including six medical professionals, in a series of Los Angeles-area health care fraud cases involving more than $1.8 billion in alleged fraudulent claims to government and private health insurance programs. Eight defendants were arrested that day; six were expected to make initial appearances that afternoon at the U.S. District Court in downtown Los Angeles, in Los Angeles County, California, and two at a federal court in Texas. The department noted that the charges are allegations and that defendants are presumed innocent unless and until proven guilty.
The largest case involves more than $1.6 billion billed in an alleged sham substance-abuse treatment scheme. Prosecutors allege that David Young, 71, also known as 'Sancho Lopez,' and Nathan Young controlled dozens of purported treatment companies, and that together with Honey Phipps, 42, and Cody Phipps, 36, they used 'body brokers' to recruit vulnerable people from around the country, bring them to Southern California and elsewhere for sham treatment, and bill private insurers. The department called it the largest sober home fraud scheme it has ever prosecuted. Nicholas Moore, described as an area manager, has pleaded guilty and admitted helping submit $199 million in fraudulent claims, according to the department.
A second case involves $134 million fraudulently billed to Medicare for medically unnecessary atherectomy procedures that prosecutors say injured patients; Anaheim cardiothoracic surgeon Harold Tabaie, 78, and Hany Malek are charged in that case. Three hospice fraud schemes account for more than $138 million in alleged false billings for patients who were not terminally ill, and another defendant was indicted in a $270 million scheme to defraud Medi-Cal, California's Medicaid program, through bogus pharmacy claims.
'These charges include the largest sober home fraud scheme the Department has ever prosecuted, and a scheme involving unnecessary invasive procedures detected through data analytics,' said Assistant Attorney General Colin M. McDonald of the Justice Department's National Fraud Enforcement Division. First Assistant U.S. Attorney Bill Essayli for the Central District of California said it is especially egregious when health care professionals who pledged to do no harm resort to greed and criminality, and that every dollar drained from public and private health insurance systems is one less dollar available to those who truly need it.
In the artery-procedure case, FBI agents surrounded a mansion in Tarzana, Los Angeles, early on October 22 and arrested Hany Malek, 61, a chiropractor. According to the New York Post, prosecutors say Malek kept an arsenal and was treated as armed and dangerous. Prosecutors allege Malek posed as a medical doctor, diagnosed patients with arterial disease they did not have and recommended the procedure, and that Tabaie then performed the procedures, including repeat procedures on the same patients.
Also charged in the same takedown was Dr. Dejun Wang, 62, of Walnut, who was indicted for the prohibited sale of prescription drug samples: prosecutors allege he sold sample drugs, including Rybelsus, Ozempic and Mounjaro, to pharmacy owners in the San Gabriel Valley, who repackaged and dispensed them to customers; prescription drug samples are promotional items that are not intended to be sold.
来源：GSM·美国（原文链接）
图片来源：图：美国司法部徽章。图片来源：美国司法部（公共领域） / Photo: Seal of the U.S. Department of Justice. Source: U.S. Department of Justice (public domain)
GSM Global · 本篇英文版 English edition of this story
- 2026-10-22 12:28Walnut医生Dejun Wang被联邦起诉：被控把Ozempic等处方药样品卖给圣盖博谷药房
- 2026-10-22 13:28司法部洛杉矶医疗诈骗大清查：15人被起诉涉虚假申报逾18亿美元 含史上最大假戒毒康复案本篇
