Two individuals in California have been arrested and charged in connection with an alleged insurance fraud scheme involving the theft of patient identities and the submission of false insurance claims.
Rebecca Juarez, 39, and Juan Pablo Rodriguez, 31, both of Irvine, were charged after the California Department of Insurance launched an investigation after several Orange County residents reported unauthorized use of their personal information.
The residents noticed charges for medical tests and treatments they did not receive on their health insurers’ explanation of benefits and contacted the Orange County Sheriff’s Department.
Authorities allege that Juarez, who worked at a Mission Viejo medical practice, accessed the facility’s computerized medical records system without authorization. Investigators say she obtained the personally identifying information of more than 21 patients and provided it to Rodriguez.
Rodriguez, who had access to a San Jose medical practice’s billing system, is accused of creating false medical records for procedures, including COVID-19 tests, that were never performed.
According to the investigation, Rodriguez submitted these false records through the San Jose practice’s insurance billing system, resulting in fraudulent claims to various medical insurers. The unauthorized billing activity reportedly took place between August and November 2023. Officials estimate the intended loss...
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