Monday, July 13, 2015

Vi Nguyen of California gets two years in prison for a scheme to defraud health insurance plans conducted in a plastic surgery center in Orange


SANTA ANA, CALIFORNIA

A 31-year-old Placentia woman was sentenced Friday to two years and three months in federal prison for her part in a scheme to defraud union and PPO health insurance plans conducted in a plastic surgery center in Orange.

Vi Nguyen was also ordered to pay $2.6 million in restitution and begin serving her time behind bars no later than Aug. 24.

Co-defendants Theresa Fisher, 45, of Tustin, and Lindsay Hardgraves, 30, of San Pedro, were sentenced last month.

Fisher, a consultant at the surgery center, was sentenced to 41 months in prison and ordered to pay $2.6 million in restitution. Hardgraves, a marketer, was sentenced to five months in prison and ordered to pay $85,000 in restitution.

Nguyen pleaded guilty to four counts of mail fraud on Jan. 16.
Fisher and Hardgraves were convicted in March following a six-day jury trial.

Fisher was found guilty of five counts of mail fraud and Hardgraves was convicted of two counts.

A large number of the fraudulent claims were submitted to the International Longshore and Warehouse Union and Operating Engineers Union health plans, as well as Aetna and Anthem.

Evidence showed insured “patients” were lured to a surgery center in Orange by being told they could use their union or PPO health insurance plans to pay for cosmetic procedures that are generally not covered.

Hardgraves found “patients” for the center, and Fisher acted as a consultant who scheduled procedures after coaching people to fabricate or exaggerate symptoms to get their medical procedures covered by their insurance, according to prosecutors.

Customers were told they could get free or discounted cosmetic surgeries if they underwent multiple medically unnecessary procedures such as endoscopies and colonoscopies that would be billed to their insurance. In return, they got no-charge tummy tucks, breast implants and liposuction.

In some instances, even the cosmetic surgeries were billed to insurance companies as medically necessary, according to prosecutors, who said the surgery center was variously known as Princess Cosmetic Surgery, Vista Surgical Center and Empire Surgical Center.