SANTA ANA, CALIF.
A cosmetic surgeon billed insurance companies for “tummy tucks” and “nose jobs” claiming these were medically necessary procedures, according to federal authorities.
They aren’t, according to authorities.
Now, the 71-year-old Dr. David M. Morrow who is also a dermatologist, is facing up to 20 years in prison. He will be sentenced on Sept. 23.
Morrow plead guilty last week to defrauding health insurance companies by submitting bills for more than $3.4 million for unnecessary medical procedures, officials said.
As part of his plea agreement, he also has to pay restitution to the victims.
The victim health insurance companies included Anthem Blue Cross, Blue Cross/Blue Shield of California, Blue Cross/Blue Shield of Massachusetts, Regional Employer/Employee Partnership for Benefits, formerly known as Riverside Employer/Employee Partnership, and Cigna.
“Insurance companies provide a valuable service by providing financial support in a time of medical need – they are not designed to dispense cash to unscrupulous medical providers,” said U.S. Attorney Eileen M. Decker. “Medical professionals who defraud an insurance provider hurt every person who is forced to pay higher premiums.”
Morrow also plead guilty to one count of filing a false tax return for 2008. Morrow admitted that he failed to report to more than $100,000 of income on his 2008 tax return and more than $1.5 million on his 2009 tax return.
Morrow, his 63-year-old wife, Linda Morrow, and Morrow’s business, the Morrow Institute, were charged in this case last fall when a federal grand jury returned a 27-count indictment that outlined a scheme.
The indictment states that patients were lured to the Coachella Valley surgery center with promises that cosmetic procedures would be paid for by their union or PPO health insurance plans, according to officials.
To trick insurance companies into paying for the cosmetic procedures, Morrow and others at the Morrow Institute completely fabricated diagnoses – such as a “hernia” – in the patients’ official medical records.
According to the indictment, they also fabricated test results and symptoms on medical records to cover up the actual medical procedures being performed – tummy tucks were fraudulently billed as hernia repair or abdominal reconstruction surgeries, and rhinoplasties or “nose jobs” were fraudulently billed as deviated septum repair surgeries.
Breast lifts and augmentations were fraudulently billed as “tuberous breast deformity,” the indictment states.
A document filed as part of Morrow’s plea agreement shows that the Morrow Institute billed insurance as much as $150,750 for a single cosmetic procedure.
Morrow altered existing medical records after the fact to conceal that cosmetic surgery had actually been performed.
Morrow admitted in the plea agreement and in court that on one patient’s medical record sent to an insurance company, he covered up the original text of “Abdominoplasty” (tummy tuck) written in the procedure section and hand wrote “umbilical & ventral hernias” on top of it.
“Dr. Morrow enriched himself by cheating policy holders and victim companies whose employees and ability to continue operating were placed in jeopardy as a result of this fraud,” said David Bowdich, the Assistant Director in Charge of the FBI’s Los Angeles Field Office. “The FBI devotes many resources to combating health care fraud and seeking justice for victims who can suffer a variety of consequences beyond financial loss.”
Charges against Linda Morrow are currently pending.
This investigation into Morrow and his business was conducted by the FBI, IRS Criminal Investigation, and the California Department of Insurance.