4 accused of insurance fraud and paying for patient referrals at Costa Mesa clinic

A Corona del Mar husband and wife and two doctors face insurance fraud charges on allegations of misleading insurers and illegally paying intermediaries to recruit patients at a Costa Mesa medical clinic, the Orange County district attorney’s office said Friday.

The four are accused of trying to defraud multiple insurance providers of nearly $3 million, according to the district attorney’s office.

Ronald Lee Martin, 68, and Veronica Martin, 63, Jeffrey Scott Catanzarite, 59, of Irvine and Max Humberto Matos, 78, of Long Beach were charged with 34 felony counts each of committing and conspiring to commit insurance fraud as well as three additional felony counts and one misdemeanor related to referrals of patients for compensation, court records show. All the charges relate to alleged crimes between March 2012 and December 2014, court records show.

The defendants pleaded not guilty to all counts Feb. 19, according to court records.

Catanzarite, a licensed chiropractor, owned and operated the medical group Center for Better Health, which had a Costa Mesa location called Southland Spine and Rehabilitation Center, where Matos, an orthopedist, was the treating physician, according to the district attorney’s office.

Prosecutors say the four defendants contracted “cappers” to obtain patients, at one point paying a rate of $1,000 per referral per week, according to court documents.

Between 2011 and 2017, Catanzarite employed Veronica and Ronald Martin through their company, Priority OneHealth Resources, to do marketing for the medical group, which also operated a clinic in Riverside, according to court documents.

Prosecutors say Catanzarite and the Martins contracted companies that they would compensate to provide patients for which the medical group would bill insurers.

The three tracked and confirmed each referral as well as the billing status of referrals through emails and spreadsheets, according to court documents.

“Catanzarite submitted claims to workers’ compensation insurance carriers and failed to disclose his unlawful procurement of patients,” the district attorney’s office said in its complaint.

As of Friday, Catanzarite’s and Matos’ medical licenses remained in good standing, according to the California Department of Consumer Affairs.

If convicted, each defendant could face a maximum sentence of 43 years and eight months in state prison, according to the district attorney’s office.

All defendants are free on $200,000 bail and are scheduled back in court May 21.