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California Lab Owner Pleads Guilty to Role in $359 Million Health Care Fraud

California Lab Owner Pleads Guilty to Role in $359 Million Health Care Fraud

A health care worker places a test swab into solution for a Covid-19 test at a testing site in Hawthorne, Calif., on Jan. 18, 2022. (Patrick T. Fallon/AFP via Getty Images)

City News Service

City News Service

10/6/2023

Updated: 10/6/2023

LOS ANGELES—A Los Angeles County medical lab owner pleaded guilty Oct. 5 to her role in a $359 million fraud scheme that exploited the COVID-19 pandemic and resulted in false billings and theft from federal programs.
Lourdes Navarro, 64, of Glendale, entered her plea to a charge of conspiracy to commit health care fraud and wire fraud, according to the U.S. Attorney’s Office.
Sentencing was set for Jan. 23, at which time Ms. Navarro will face up to 20 years in prison, federal prosecutors said.
Ms. Navarro ran Baldwin Park-based Matias Clinical Laboratory Inc., also known as Health Care Providers Laboratory, a lab she operated, controlled and managed with husband Imran Shams. The lab performed COVID-19 screening tests for nursing homes and other facilities with vulnerable elderly populations, as well as primary and secondary schools.
To increase its reimbursements, Ms. Navarro fraudulently added claims for respiratory pathogen panel tests even though providers and facility administrators did not want or need them, according to her plea agreement filed in Los Angeles federal court.
The couple carried out the scheme to submit false and fraudulent claims to Medicare, the HRSA’s COVID-19 Uninsured Program, and an insurance company for respiratory pathogen panel testing that was not ordered, medically unnecessary, procured through illegal kickbacks and bribes, and ineligible for reimbursement, prosecutors said.
Los Angeles County Sheriffs Department deputies stand outside a medical center in Lynwood, Calif., on Sept. 13, 2020. (Patrick T. Fallon/Reuters)

Los Angeles County Sheriffs Department deputies stand outside a medical center in Lynwood, Calif., on Sept. 13, 2020. (Patrick T. Fallon/Reuters)

Mr. Shams, 65, previously pleaded guilty to conspiracy to commit health care fraud and is scheduled to be sentenced on Jan. 9.
The U.S. Attorney’s Office said the couple paid kickbacks for specimens and test orders, and laundered profits through shell companies and the purchase of real estate, luxury items and personal goods and services.
Mr. Shams had been excluded from all participation in Medicare since he and Ms. Navarro were convicted in 2000 on felony counts of Medi-Cal fraud, grand theft, money laundering and identity theft, according to court documents.
The couple concealed Mr. Shams’s role in the lab and his prior convictions, prosecutors said.
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