SANTA ANA, Calif. – A Beverly Hills surgeon charged with stealing nearly $29 million in an elaborate insurance fraud scheme that involved hiring body brokers to pay patients at Southern California sober living homes to undergo medically unnecessary surgeries, medical testing, and other medical procedures has been ordered to be released from the Orange County Jail after he tested positive for COVID-19. Four others have been charged in connection with the illegal operation.
Dr. Randy Rosen pleaded not guilty on July 2, 2020 to 88 felony counts in two separate cases in connection with recruiting and hiring numerous body brokers to find and pay patients to have medically unnecessary Naltrexone implant surgeries and cortisone shots.
After a complicated two-and-a-half-month preliminary hearing, a judge found on October 1, 2020 there was sufficient evidence to hold Rosen to answer for trial on all 68 felonies as well as all the alleged enhancements and allegations in Case #20CF1682. His bail was set at $10 million.
Rosen is a significant flight risk due to millions of dollars in assets still available to him and the fact that he faces more than 80 years in state prison if convicted on all charges. Dr. C. Hsien Chang, who serves as the Medical Director for Orange County’s Correctional Health Services (CHS), authored a declaration supporting Rosen’s continued incarceration, stating “I am familiar with Randy Rosen’s medical conditions and have complete confidence that CHS can appropriately manage and treat his medical conditions while in the Orange County Jail.”
The Orange County District Attorney’s Office objected to the release of Rosen, arguing that he poses a significant risk to the community if released due to the “massive network of body-brokers amassed by the defendant, the sheer number of medically unnecessary procedures performed on vulnerable drug-addicted patients” and the extended span of time in which the criminal activity was conducted. Rosen was out on $300,000 bail in another criminal case when he continued to engage in insurance fraud through his body broker scheme, prosecutors argued.
A judge ordered Rosen released back to his Los Angeles home under electronic monitoring for up to 30 days.
“We are watching the theater of the absurd,” said Orange County District Attorney Todd Spitzer. “The criminal justice system shouldn’t have one set of rules for people who are wealthy and a separate set of rules who aren’t. Poor people who pose a low risk to society shouldn’t have to sit in jail because they can’t afford to get out while wealthy people who have demonstrated they have no regard for the law or the lives of other human beings and have nothing to lose walk right out the front door of the jail.”
Prosecutors have charged Rosen with billing numerous insurance companies for the unnecessary procedures performed on drug-addicted patients. The patients were never informed of the fact that patients were being trafficked and paid for these procedures. Due to this massive scheme and conspiracy, the insurance companies were fraudulently billed approximately $135 million and paid out approximately $29 million dollars.
Rosen’s girlfriend Liza Visamanos, 41, of Los Angeles, pleaded not guilty on July 2, 2020 to 56 felony counts in two separate cases in connection with the scheme.
Rosen, 57, of Los Angeles, and Visamanos were arrested June 30, 2020 by the Orange County District Attorney’s Office on nearly $52 million warrants which equals the amount stolen as a result of the scheme.
In addition to submitting patients to medically unnecessary procedures, it is alleged that Dr. Rosen also required the patients to undergo unnecessary drug tests which he sent to Lotus Laboratories, which is owned by his girlfriend, for testing. California law prohibits such referrals where the physician or his immediate family has a financial interest with the person or entity receiving the referral. It is alleged that Lotus Laboratories fraudulently billed at least 22 different insurance providers more than $3 million.
Robert Mellon, 52, of San Diego, Thomas Douglas, 29 of Playa del Rey, Shea Simmons, 28, of Jeanerette, Louisiana, and Patrick Connolly, 28, of Los Angeles, also face felony charges for their involvement in the scheme.
Summary of Charges and Defendants – Health Insurance Fraud Cases
As part of the Health Insurance Fraud scheme, Dr. Rosen, (Case No.20CF1682), is charged with eight counts of Creating Documents For Purposes of Submitting False or Fraudulent Insurance Claims, eight counts of Submitting False or Fraudulent Insurance Claims, eight counts of Withholding Material Facts on Insurance Claims, eight counts of Conspiracy to Commit Unlawful Patient Referrals, and sixteen counts of Money Laundering. He is also charged with White Collar Crime Enhancements as the amount of loss exceeded $500,000 and a crime-bail-crime enhancement for committing additional crimes while released on bail on his previous and still active insurance fraud case in People v. Randy Scott Rosen (Case No. 16CF1363). If convicted on all counts, he faces a maximum of 84 years and eight months in state prison.
Liza Vismanos, (Case No. 20CF1685), is charged with eight counts of Creating Documents For Purposes of Submitting False or Fraudulent Insurance Claims, eight counts of Submitting False or Fraudulent Insurance Claims, eight counts of Withholding Material Facts on Insurance Claims, and eight counts of Conspiracy to Commit Unlawful Patient Referrals. She is also charged with White Collar Crime Enhancements as the amount of loss exceeded $500,000. If convicted on all counts, she faces a maximum of 36 years and four months in state prison.
Thomas Douglas, (Case No.20CF1684), is charged with eight counts of Creating Documents For Purposes of Submitting False or Fraudulent Insurance Claims, eight counts of Submitting False or Fraudulent Insurance Claims, eight counts of Withholding Material Facts on Insurance Claims and eight counts of Conspiracy to Commit Unlawful Patient Referrals, and twenty-seven counts of Money Laundering. He is also charged with White Collar Crime Enhancements as the amount of loss exceeded $500,000. If convicted on all counts, he faces a maximum of 68 years and eight months in state prison.
Robert Mellon, (Case No. 20CF1683), is charged with eight counts of Creating Documents For Purposes of Submitting False or Fraudulent Insurance Claims, eight counts of Submitting False or Fraudulent Insurance Claims, eight counts of Withholding Material Facts on Insurance Claims and eight counts of Conspiracy to Commit Unlawful Patient Referrals. He is also charged with White Collar Crime Enhancements as the amount of loss exceeded $500,000. If convicted on all counts, he faces a maximum of 36 years and four months in state prison.
Shea Simmons, (Case No. 20CF1681), is charged with eight counts of Creating Documents For Purposes of Submitting False or Fraudulent Insurance Claims, eight counts of Submitting False or Fraudulent Insurance Claims, eight counts of Withholding Material Facts on Insurance Claims, eight counts of Conspiracy to Commit Unlawful Patient Referrals and eleven counts of Money Laundering. He is also charged with White Collar Crime Enhancements as the amount of loss exceeded $500,000. If convicted on all counts, he faces a maximum of 45 years and four months in state prison.
Patrick Connolly, (Case No. 20CF1677), is charged with eight counts of Creating Documents For Purposes of Submitting False or Fraudulent Insurance Claims, eight counts of Submitting False or Fraudulent Insurance Claims, eight counts of Withholding Material Facts on Insurance Claims and eight counts of Conspiracy to Commit Unlawful Patient Referrals, and nine counts of Money Laundering. He is also charged with White Collar Crime Enhancements as the amount of loss exceeded $500,000. If convicted on all counts, he faces a maximum of forty-five years and four months in state prison.
Summary of Charges and Defendants – Workers’ Compensation Fraud Cases
As part of the Workers’ Compensation scheme, Dr. Rosen is charged with twenty-four counts of Withholding Material Facts on Insurance Claims and seventeen counts of Creating Documents for Purposes of Submitting False or Fraudulent Insurance Claims. Vismanos is charged with twenty-four counts of Withholding Material Facts on Insurance Claims. The couple was also charged with the aggravated white collar crime enhancement for losses exceeding $100,000 and $500,000. Dr. Rosen is charged with a crime-bail-crime enhancement pursuant to Penal Code Section 12022.1(b) for committing additional crimes while released on bail on his previous and still active insurance fraud case in People v. Randy Scott Rosen (Case No. 16CF1363).
As part of the Workers’ Compensation Fraud case, Dr. Rosen is facing a maximum of 51 years in state prison if convicted on all charges.
As part of the Workers’ Compensation Fraud case, Liza Vismanos is facing a maximum of 31 years in state prison.
Deputy District Attorney Vincent Marinaccio of the Insurance Fraud Unit is prosecuting defendants Dr. Rosen and Vismanos’ workers’ compensation fraud cases.
Deputy District Attorney Jim Bilek of the Insurance Fraud Unit is prosecuting defendants Dr. Rosen, Vismanos’, Douglas’, Simmons’, Connolly’s, and Mellon’s health insurance fraud cases.
No, let him rot in prison.