SANTA ANA : False Medical Claims Cited in Indictment

The Orange County Grand Jury has indicted a Santa Ana chiropractor and his nephew on charges of filing false insurance and medical claims in exchange for payments, prosecutors announced Tuesday.

Chiropractor Emilio Abitia, owner of the Santa Ana Professional Health Center, allegedly falsified documents stating that clients were disabled, allowing them to collect state disability insurance benefits for nonexistent injuries, officials charged.

Abitia’s nephew, Roberto Vallarino, an office manager, allegedly signed Abitia’s name to some documents certifying healthy people as disabled, Deputy Dist. Atty. Michael T. Lubinski said.

Abitia and Vallarino were allegedly paid a fee in exchange for each falsified disability claim, but authorities are also investigating whether the men received a portion of the insurance checks.

Authorities are also seeking refunds from people who filed false claims and received the insurance benefits, Lubinski said. If they can be located, the recipients also face arrest.

Abitia and Vallarino could not be reached for comment. It was unclear whether they have hired attorneys. Vallarino also faces felony insurance fraud charges in Los Angeles, Lubinski said.

Disability payments are awarded to individuals who are injured and unable to work for extended periods of time.

The extent of the alleged fraud must still be determined. But the results of an undercover investigation between October and March revealed false claims worth several thousand dollars, Lubinski said.

The fraud could be more far-reaching, he added.

“That was just with our undercover investigation,” said Lubinski, who added that state officials are looking into the possibility of shutting down the chiropractor’s business. “They were pretty blatant.”

In one case, Abitia and Vallarino allegedly submitted a medical bill for $2,819.70 and claimed that they had examined a patient, taken X-rays and provided therapy. In fact, the undercover officer posing as a client was never examined, Lubinski said.

“What’s so infuriating about this is that there are people who really need these benefits and guys are stealing from the system,” he said.

Clients were attracted to Abitia’s office through word of mouth, Lubinski said.

State Employment Development Department documents show that between March, 1990, and March, 1993, Abitia’s name appears on more than 900 disability certificates that resulted in the state’s paying more than $2.3 million in claims, Lubinski said. Such totals are unusually high for a single practitioner, he said.

Abitia and Vallarino were arrested Tuesay and are expected to be arraigned today in Orange County Superior Court. The eight-count felony indictment includes one count of grand theft, two counts of filing false insurance claims to private firms and two counts of conspiracy to file false claims with the state.