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OC doctor pleads guilty in $20M MediCal fraud scheme | #phishing | #scams | #hacking | #aihp


An Orange County physician pleaded guilty Wednesday to orchestrating a scheme to defraud Medi-Cal out of $20 million.

Mohamed Waddah El-Nachef, 69, of Laguna Hills, pleaded guilty to executing a scheme to defraud Medi-Cal, fraudulent claim for a health benefit, fraudulent insurance benefit claim, false or fraudulent claims, solicitation, acceptance or referral of business, conspiracy or aiding and abetting unauthorized practice of medicine, and grand theft, all felonies. He also admitted sentencing enhancements for aggravated white collar crime between $100,000 to $500,000.

He is scheduled to be sentenced Aug. 1 of next year.

The doctor will be required to pay $2.3 million in restitution and surrender his medical license, according to the Attorney General’s Office, which prosecuted the case.

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“El-Nachef used his position as a physician to steal taxpayer money from our state programs and fuel illicit pharmaceutical sales on the streets of Southern California — all for personal gain,” Attorney General Rob Bonta said in a statement. “Today, he was held accountable and ordered to give back what he took from the people of California. Abuses of power — whether big or small -— will never be tolerated by the California Department of Justice. As the people’s attorney, I will continue to protect the programs designed to help our most vulnerable residents.”

El-Nachef helped “two convicted felons, Steve Fleming and Oscar Abrons, in a scheme to obtain expensive pharmaceuticals that were sold on the illicit market,” according to court papers filed by the state Attorney General’s Office when the doctor was charged in March of 2020.

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El-Nachef “wrote prescriptions for HIV medications, anti-psychotics, and opioids to over 1,000 medical beneficiaries brought to him by Fleming and Abrons,” the court papers said. “El-Nachef never conducted good-faith medical exams or otherwise validated that the patients actually needed the drugs he prescribed. A vast majority of the patients did not have HIV, nor had a legitimate need for the psychotic medications or controlled drugs. The medicines were paid for by Medi-Cal, which was unaware that El-Nachef’s prescriptions were generated as part of a fraud and drug trafficking scheme.”

The scheme was carried out from June 2014 through April 2016, according to prosecutors. The doctor was prescribing the drugs at two clinics — one in Anaheim and another in Los Angeles, prosecutor said.

The doctor’s attorney, Christopher Jude Bou Saeed, did not immediately respond to a request for comment.

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