Oxnard Clinic Among 17 Named in Fraud Lawsuit

A Ventura County clinic is one of 17 medical groups named in a $33-million insurance fraud lawsuit filed by Allstate Insurance Co., officials said Wednesday.

The lawsuit accuses 11 doctors at medical clinics from Orange County to Oxnard of “upcoding” insurance claims to reflect artificially higher billing costs.

“What they did was the systematic practice of bilking the insurance companies,” said Dennis B. Kass, a Los Angeles attorney representing Allstate Insurance.

A 10-month investigation launched by the company’s fraud unit allegedly found that invoices on 549 patients, 31 of whom were treated in Ventura County, consistently used the most expensive medical codes to reflect a higher level of care than patients received, Kass said.

“The codes they were using essentially are telling us that these are critically injured people,” he said. “Instead of getting a $500 to $600 bill, we were getting a $3,000 to $5,000 bill.”

The civil action, which was filed under seal in Los Angeles County Superior Court on July 29, makes use of a 1995 insurance regulation that holds anyone taking part in the submission of a fraudulent claim responsible.

Among the 11 doctors named in the suit was Dr. Richard B. Harp, whose signature is on 31 claims, Kass said. Harp worked out of the now-defunct Oxnard Medical Clinic, at 1300 N. Ventura Blvd.

Harp could not be reached for comment, nor could Dr. Arthur G. Collins, owner of all 17 medical groups, including the one in Oxnard.

Allstate is seeking damages from the defendants equal to three times the amount of the insurance claims, plus attorneys’ fees and a $10,000 civil penalty for each violation.

If damages are awarded, a portion of the money will go toward the California Department of Insurance’s general fund to help combat fraud, said Deputy Commissioner Dana Spurrier.

The Ventura County district attorney’s office hasn’t determined whether criminal fraud charges would be pursued, office officials say.