LOS ANGELES–Filipino American doctor Ovid Mercene has pleaded guilty to federal tax charges, admitting participation in a large-scale scheme to defraud Medicare and Medi-Cal.
From 2008 to 2012, the 61-year-old Mercene of La Mirada in southeast Los Angeles County, admitted mostly homeless patients from LA’s Skid Row for treatment they did not need, as a means of defrauding the taxpayer-funded health programs, according to the US Attorney’s office.
The internal medicine practitioner pleaded guilty on Thursday, Dec. 12, before U.S. District Judge R. Gary Klausner of the Central District of California. Judge Klausner has set Mercene’s sentencing on July 21.
Authorities said Mercene’s case was the first of an ongoing investigation into the recruiting of Skid Row patients by several state and federal agencies, including the FBI, the Internal Revenue Service, US Department of Health and Human Services, Office of Inspector General and the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse.
The US Attorney’s office said that during a period of six years Mercene admitted mostly homeless patients at a Los Angeles-area hospital based on referrals from a purported “care consortium.”The name of the hospital was not released because the investigation is ongoing, authorities said.
Mercene billed Medicare and Medi-Cal, the California counterpart of Medicaid, more than $1.8 million for medically unnecessary services. He was paid $850,000 and also received $700,000 in cash for referring these patients into skilled nursing homes, according to the US District Attorney’s office.
Officials said Mercene did not report the income on his tax returns. According to authorities, Mercene knew that many of the patients were transported from downtown LA’s Skid Row and not from a supposed “care consortium.”
He admitted the “patients” at a location a floor away from regular hospital patients and gave some of them smoking breaks even though they suffered from respiratory ailments, the US District Attorney’s office said.
Mercene would administer numerous unnecessary tests and discharge the patients to nursing facilities even though they did not require that kind of care. Mercene then billed Medicare and Medi-Cal for medical services the Skid Row patients did not need while in the hospital or at a skilled nursing facility.