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CA woman gets eight years in prison for recruiting patients for needless surgery

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California

A California woman has been sentenced to eight years in prison for a massive health insurance fraud scheme which recruited people for unnecessary surgeries.

Lilia Toscano has pleaded guilty to 98 counts including conspiracy, grand theft, tax evasion and "capping" (recruiting patients for a fee). She signed up more than 245 people to take part in the needless procedures in exchange for money or low-cost cosmetic procedures. Other "cappers" involved in the scheme worked in a total of 39 states, recruiting a total of 2,841 people to get the surgeries.

Ultimately, health plans were billed more than $10 million for surgeries, and paid more than $2.5 million for patients recruited by Toscano, who herself received $770,000.

A total of 19 people were involved in the scheme, including three doctors, who performed a total of 1,037 medical procedures.

To learn more about the case:
- read this Los Angeles Times piece

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