California Attorney General Rob Bonta negotiated an $11.4 million settlement with a pain management clinic after allegations of Medi-Cal fraud.
Lags Medical Clinics — owned by Dr. Francis Lagattuta — operated 28 clinics in California and especially the Valley. There were three in Fresno.
Bonta, along with the U.S. Department of Justice, alleged that Lagattuta had been conducting unnecessary tests and procedures on thousands of patients, billing Medi-Cal and Medicare for the services.
“Thousands of Medi-Cal patients trusted Dr. Lagattuta to take away their pain,” Bonta said in a news release. “Instead he exploited their trust by carrying out arrays of unnecessary tests and billing for them over the objections of the doctors he employed.”
Unnecessary Procedures Conducted on Patients
Lagattuta had told employees at his clinics to conduct procedures on patients regardless of whether they needed them or not, the investigation found.
Procedures such as skin biopsies, spinal cord stimulation, and urine drug testing were done often without patient consent.
Medi-Cal and Medicare would then be billed for the services.
“Dr. Lagattuta and Lags Medical engaged in a brazen scheme to defraud Medicare and Medicaid of millions of dollars by inflicting unnecessary and painful procedures on patients whom they were supposed to be relieving of pain,” said U.S. Attorney Phillip Talbert.
Patient Care Ended Abruptly
KHN also reported the clinic served 20,000 patients throughout the Valley and Central Coast.
The California Department of Health Care Services soon after suspended Medi-Cal payments to Lags Medical Clinic because of an investigation into Dr. Francis Lagattuta’s practice.
Fresno County Lawsuit
A lawsuit filed in Fresno County alleged that a Lags Medical provider in Fresno punctured a patient’s lung during a botched injection for back pain. Lagattuta and the other named defendants have denied the incident was due to negligent treatment, KHN reported.
Former employees said they were given bonuses if they treated more than 32 patients in a day, a strategy Lagattuta confirmed in his deposition for the malpractice lawsuit.
“If they saw over, like, 32 patients, they would get, like, $10 a patient,” Lagattuta testified.
Of the $11.4 million, $8.5 million will go to the federal government. California will receive $2.7 million and Oregon will receive $130,000.
Lagattuta will be barred from receiving any Medi-Cal reimbursement or be allowed to bill Medi-Cal for five years.