Castro Valley Doctor is Charged for Insurance Fraud Scheme

A Castro Valley doctor and his office manager have been charged for an alleged insurance fraud scheme, Alameda County District Attorney Nancy O’Malley said today. The charges against Dr. Douglas Abeles and Gabriela Cuevas, his office manager, indicate that for several years he falsely and fraudulently billed insurance companies for medical services that weren’t provided, O’Malley said.

Abeles had an orthopedic medical practice in Castro Valley but also owned and operated at least four medically-related businesses from an office at a different location at the Castro Valley-Hayward border, according to O’Malley. Cuevas managed those businesses for Abeles, she said.

The businesses included drug testing urine analysis for medical offices that contracted with Abeles and it was through the businesses that Abeles and Cuevas allegedly fraudulently billed insurance companies for lab reports, O’Malley said. Abeles has been charged with 31 felony counts, including insurance fraud, grand theft, conspiracy, filing false claims and false personation of another.

Cuevas has been charged with multiple counts of the same offenses. O’Malley said the charges were filed following a joint investigation by her office and the California Department of Insurance and Abeles surrendered on an arrest warrant. She said the investigation “required extensive and diligent investigative work, entailing the meticulous collection of evidence,” because large insurance fraud schemes are often highly sophisticated.

State Insurance Commissioner Dave Jones said, “This physician’s systemic abuse of the medical services system inflates premiums for all Californians who eventually end up footing the bill for this type of fraud.” Jones said, “Our detectives, investigators and law enforcement partners spend countless hours to root out those who abuse the insurance system for their own personal financial gain. The Alameda County DA’s Office was an invaluable partner in moving this case forward.”

By Bay City News