Doctor Indicted in Inflated Bill Scam : Physician, Company Allegedly Overbilled at Scripps Hospital Emergency Room
A physician who formerly directed emergency room doctors at Scripps Memorial Hospital was indicted Thursday by a federal grand jury on 44 counts of defrauding patients and insurance companies of $400,000.
Robert Eggold, 39, who is now practicing medicine in another state, and his company, Emergency Care Medical Group Inc., were accused of defrauding several private insurance companies, Medicare and patients. Eggold directed emergency room doctors at Scripps for 10 years, but Assistant U.S. Atty. George Hardy said the fraud counts stem from a spot auditing of emergency room billings for the months of August, 1983, and September, 1984.
A complete audit of 10 years of billings “would be functionally impossible,” Hardy said. He added that U.S. prosecutors will file a civil suit seeking restitution if Eggold is convicted on the fraud counts.
According to the charges, Eggold inflated billings by charging for services that were never rendered. As head of the team of emergency room doctors, Eggold also submitted inflated billings for other physicians, the indictment states. The indictment names three physicians whose patients or their insurance companies also were forced to pay inflated charges.
However, the doctors were not charged in the indictment and it was not known if they were aware of the scheme or if they are under investigation. Hardy declined to say where Eggold is now practicing medicine. Eggold, who is scheduled to surrender to U.S. marshals by Dec. 30, and his attorney, Cheryl Ruffier, could not be reached for comment.
Eggold officially resigned from Scripps in September, 1985, after allegations of overcharging surfaced. On Aug. 21, 1985, the hospital ended its contract with Emergency Care Medical Group Inc. to manage and bill for doctors’ services. At the time, Eggold was president of the company and had eight doctors working for him.
Two days after ending their contract with Eggold’s company, Scripps officials notified the Health Care Financing Administration, the federal agency that oversees Medicare, of the allegations concerning billing irregularities.
Eggold’s medical group also provided doctors for emergency rooms at Mission Bay Hospital in San Diego and El Centro Community Hospital in El Centro. On Thursday, Hardy said that U.S. investigators are aware of Eggold’s ties to the other two hospitals, but he declined to say if they are looking into billing practices there.
During Eggold’s tenure at Scripps, doctors were treating an average of 1,300 emergency room patients a month. Of these, about 200 were Medicare patients.
Times staff writer Jim Schachter contributed to this story.
