Doctors Suspected of Fraud Investigated Before

The former chief of obstetrics at High Desert Hospital and two other physicians suspected of double billing the state’s Medi-Cal program were investigated for the same offense four years ago, according to court documents obtained by The Times.

The doctors are Calvin N. Ladner--the former head of obstetrics, who earned $135,000 a year from his county employment alone--and physicians Samy F. Farid and Dietmar Habeck

The three are under investigation for allegedly illegally billing the Medi-Cal program for services they were already being paid to perform as employees of Los Angeles County, according to a document in a court file prepared by an investigator for the state attorney general. Investigators seized records of more than $3 million in Medi-Cal billings from 1991 to 1995 by the three doctors, according to the court file. Officials did not estimate what portion of the total they suspect might be the result of double billing.

The doctors were investigated earlier for alleged “improper and illegal billing of the Medi-Cal Program,” and all were given memorandums to sign that acknowledged that double billing is improper, according to the court file. The Oct. 7, 1991, memo stated in part, “ . . . you are not permitted to bill Medi-Cal for patients identified as county patients.”

County health officials said that at the time of the 1991 probe, they had no basis on which to take stronger action.

Fred Leaf, chief of the inspection and audit division for the Department of Health Services, said that when investigators pursued complaints about billing irregularities, they learned that High Desert Hospital had failed to establish clear guidelines for physicians or internal controls to pinpoint fraud.

The hospital “did not provide adequate . . . direction to hold the doctors accountable for what they were doing, plus we couldn’t determine exactly what they might have been doing,” Leaf said.

As a result, the hospital instituted internal controls, including a more rigorous time-keeping system for county physicians such as Ladner, Farid, and Habeck, who were also in private practice. Those controls have allowed investigators to pursue the current case, Leaf said.

The three doctors no longer work for the county health department, said High Desert’s administrator, Mel Grussing.

Ladner, 60, and Haybeck, 55, both longtime county employees, retired during last year’s county layoffs, shortly after they became aware of the investigation, Grussing said.

The 46-year-old Farid, he said, resigned about the same time.

A fourth High Desert doctor, Parviz Hakimi, is also being investigated in regard to Medi-Cal billing, according to the court file, but Hakimi was apparently not involved in the 1991 investigation. Hakimi works at the Antelope Valley Health Center in Lancaster “under direct supervision, and is not involved in billing,” Grussing said.

Farid and Hakimi could not be reached for comment but in the past have maintained their innocence.

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Habeck in a telephone interview Friday said he and the others have nothing to hide.

He said the ’91 investigation produced “no negative findings of any sort” and that the current probe caught him and his colleagues by surprise.

“We understand that we are accused of double billing, [but] as far as I know, nobody did any double billing,” Habeck said. “I didn’t do any double billing. I talked to my colleagues, and they didn’t do any double billing, either.”

Habeck said the investigation is not only embarrassing but unjust. “We gave a good deal of our effort and sleepless nights . . . in serving the underprivileged of the county for very scant pay,” he said.

Ladner’s attorney, David Durchfort, said the case involves misunderstandings but “absolutely no intent to overbill.”

He said there was confusion between the hospitals and the doctors’ private offices as to “whose patients were whose” and that this continued after the county supposedly implemented the internal controls in 1991. “We dispute the contention that . . . fail-safe procedures were implemented to clear up the double-billing misunderstanding,” Durchfort said.

From 1991 to 1995, according to the investigator’s report, Farid collected about $1.4 million in Medi-Cal billings; Habeck took in $982,315; Ladner received $765,300, and Hakimi collected $68,000.

No charges have been filed in the current investigation, which Tom Timmerman, head of the attorney general’s Medi-Cal fraud investigation unit, described as continuing.

“At this point, we can’t say much because there is more information we need to process,” Timmerman said.

Questions about the billing practices of some of doctors in High Desert’s obstetrics department were raised in 1994 after state Medi-Cal officials refused to reimburse the county facility for the delivery of several babies. Medi-Cal officials told High Desert employees that state records indicated that Medi-Cal had already made the required reimbursements.

According to the statement signed by state attorney general investigator Paula Seiberlich, Candy Smith--at the time, High Desert’s budget chief--examined baby delivery records for various Medi-Cal recipients.

On the majority of the forms reviewed, Ladner was the physician delivering the baby. Smith then pulled Ladner’s corresponding time card, which showed that Ladner was employed on county time when these deliveries took place, Seiberlich wrote.

The state now suspects four of the five physicians who made up High Desert’s obstetrics program--which was operated in conjunction with privately run Antelope Valley Hospital--of double dipping on their Medi-Cal claims, according to the court file.

“Contrary to what was billed to the program, each doctor performed childbirth deliveries while serving within the 40 hours due the county under normal terms of their full-time county employment,” according to the court file.

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Investigators allege the doctors lied about the dates or the procedures and used billing codes to fool the Medi-Cal billing system.

For instance, the document filed by the state investigator alleges:

* During at least eight births reviewed by the state investigators, Ladner was paid by Medi-Cal but was apparently not in the room when the deliveries occurred.

* For three births, Habeck and Ladner used various codes and childbirthing procedures to successfully bill Medi-Cal for eight payments.

* While Ladner billed Medi-Cal for treating 16 county patients and collected about $9,000, the county received nothing.

During a search last November, authorities confiscated documents at both High Desert and Antelope Valley hospitals, the offices of the physicians, and the firms the doctors used for their private practice Medi-Cal billing, according to the court file.

Among the items investigators seized were patient records, billing statements, tax filings and appointment books for the years 1991 through 1995. The investigators also requested information from banks where the doctors had accounts, and collected data such as checks drawn and ATM withdrawals, according to the warrant.

Times staff writer Myron Levin contributed to this story.