Doctor’s Orders | 5. Ashes to Ashes

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How much is the pain in your left shoulder?

On the scale of 0 to 10.

Sometimes like all the way up to like 8.

8?

Yeah.

This is an undercover agent visiting a frontline medical office.

It was recorded in March 2013, so just before Kelly Supark was tried for Juliana Redding's murder.

Any other problem?

No, that's it.

That's it.

The agent, or patient, says his shoulder hurts a lot.

The doctor is sitting at a desk across the room.

He gets up, walks over, examines the shoulder for a solid 20 seconds.

Does it check like that?

Uh,

a little bit, but it's mostly like mostly inside inside.

Yeah, do it like that.

And I want you to think for a moment about trust.

When the agent walked in for his appointment, he thought he was meeting with a Dr.

Johnson.

When he asked the doctor's name,

he says, I am Dr.

Gubran for Dr.

Johnson.

Oh, okay.

How do we know this man is a doctor?

Okay, he's wearing a long white coat and a tie.

He's older, maybe in his 60s.

He has white hair.

He works in a medical office, and all the people in this medical office, let's just assume, they've all indicated that this man is a doctor.

So any normal person would trust he's a doctor.

I would.

Okay.

I'm going to

order MRI on left shoulder.

But what if he's not?

What if you've fallen into a medical bizarro world where all the rules are upside down?

Would you even know?

Could you even know?

This appointment lasts less than three minutes.

The doctor, well, let's just say the man in the white coat, orders an MRI, some medicine for the patient, and then sends him on his way.

You can go now.

Okay, that's it.

That's it.

Okay, thank you.

In 2015, when the Los Angeles County District Attorney unsealed two indictments, they included 132 felony counts against 15 named defendants.

The most serious charges are 18 counts of aggravated mayhem against those who conspired to deceive patients into having surgeries performed by a man who was not a doctor.

Munir Ueda and 11 others faced up to life in prison.

I'm Benadair from Sony Music Entertainment and Western Sound.

You're listening to Doctor's Orders.

This is episode 5, Ashes to Ashes.

By By the time Santa Monica homicide detectives raided a storage space and discovered a trove of documents, over 100 boxes, they said, Munir Ueda's medical empire had grown and grown.

Investigative auditors will eventually dig into 115 different bank accounts, both business and personal accounts, that they believe might be related to the fraud.

Total funds deposited into these accounts between January 2003 and October 2014 were over $272 million.

They found millions in international transfers, a lot to Estonia, a lot to Lebanon.

And they found that the international transfers increased after 2010, which, coincidentally or not, was the year that Munir Ueda left the United States.

Eventually, forensic auditors focused on 24 bank accounts and a few personal ones relating to those indicted, including one for Kelly Sioux Park.

They analyzed the flow of money between these accounts and found, over a four-year period, almost $185 million moving through them.

Though Munir was not a signer on any of these accounts, prosecutors believe he was the common denominator, controlling what went in and what went out.

So, of that $185 million,

how much of that was legit business?

How much of that was fraud?

What was the balance of unneeded, unnecessary, destructive care versus legitimate, helpful, healing care?

This is what prosecutors had to figure out.

In 2010, the LADA's office created a special task force to try to see what was going on.

In 2012, this guy.

My name is Dayon Mathai.

Career prosecutor Dayon Mathai joined it.

And what we discovered was not only health care fraud, but there was fraud happening in multiple areas that went beyond just simple billing fraud.

It was much more massive.

It involved lawyers, doctors, physicians' assistants, real estate agents.

It was widespread and touched on different areas.

Investigators begin to uncover what they say was a very sophisticated operation and a sprawling one.

All designed to do one thing, move patients through as much care as possible and bill, bill, bill, bill, bill.

With little or no regard, they say, to the patients themselves and what happened to them.

Take someone like Jenny Malone, who we heard from a couple episodes ago.

I was at a trade show for work and I fell down and I needed to let my boss know that I wasn't going to go into work on the following Monday.

So I just wanted to go get it checked to make sure that everything was still okay.

Remember, Jenny chose a frontline medical office because it was convenient.

She went in and suddenly, wham, all these things started happening.

The doctors there, after they did all of these x-rays and then the MRIs, they told me that I'm going to need surgery.

And I was like, oh my God, you know, why?

So Jenny, who's coming in just to get something checked out, she might have been like, I don't know, a few thousand in billing.

Suddenly, she's over a million.

I want to play a little bit more of her story, as messed up as it is.

And as you listen, I want you to imagine it from a billing point of view, where every interaction, every intervention is a billable opportunity.

So after gauze was left in her arm during surgery.

I think I waited for a full week before I went back in, even though I was in pain, but I figured that's normal.

I just had surgery.

Then the pain just kept progressing and getting really, really bad.

And I went back in probably like two or three days after my follow-up.

From that point on, I was going to the medical clinic at least twice a week.

It just hurt so bad.

I can't even describe it.

And I was like popping pills.

I should take two every four to six hours, but then I'm taking more and more and nothing would make the pain go away.

I knew that something wasn't right because I had a fever.

and I'd go in, they would give me a shot and then I'd be better for a day or two and then all of a sudden it would start up again.

So then my father-in-law, he was like, oh yeah, fever's back, we're going to go back there, we got to go back.

They just kept giving me a shot and telling me that it's okay for me to take more pain pills.

And they gave me bottles of pain pills there, even though I had bottles that were already sent to my house.

And I mean, I would get two great big bottles of Vicodin at a time.

And then when I was there, they gave me a bottle of Vicodin.

They did that for many weeks before they looked into giving me an x-ray.

This 1,000% inverts what healthcare is supposed to be.

Just think about it.

If your goal is money, you want to be continually giving people more care.

And you know who doesn't need more care?

People who get better.

Patients who get well are money left on the table.

On the other hand, bad outcomes are rewarded with cash.

Prosecutors digging into Frontline and Munir's associated companies say they quickly found he's got it on lock.

He's making money from all around that healthcare wheel of fortune.

Once you get that referral to the medical clinic, Prosecutor Dan Mathai, the patient would go see a doctor.

The doctor would say, okay, I'm going to give you two medications for your pain.

You don't have to go to the pharmacy.

It's going to be shipped to you.

You're also going to get an MRI.

Do you need translation services?

Do you need transportation services?

Do you have problems sleeping?

Do you have problems with your nerves?

I'm going to refer you to all these specialists.

So the patient's thinking, that's great.

I'm going to get all this medical attention.

What the patient didn't know is that the same person that owned the medical clinic, Ueda, also owned or controlled all of these other healthcare providers.

We've heard this before.

Let's hear it again.

The patient was was basically like an ATM machine.

And because Workers Comp Medicine is completely paid by employers and their insurance companies, the patients had no clue what was going on.

The patient never gets an explanation of what's built.

So it's just between the doctor and insurance company.

So the patient's in the dark about what they get built.

There's a lot more.

The fraud, prosecutors say, just kept going and going.

They say they found falsified patient records with forged signatures, prescriptions nobody asked for, doctors masquerading as other doctors.

Or were they even doctors at all?

Who knows?

One frontline employee would later testify in open court that if she ever saw a negative MRI, which negative means nothing wrong, she was told to correct it.

and help get more unnecessary surgeries on the books.

Another frontline employee testified to getting financial bonuses for falsifying documents to, again, get more authorizations for more unnecessary surgeries.

Do we know how many of those unnecessary surgeries were botched?

We do not.

Prosecutors even allege that Munir paid some patients to convince them to get surgery.

And there's a whole other kickback side to it, where non-medical people in the workers' comp system would get paid to refer patients into the frontline web of companies.

Prosecutors say they discovered companies run by Munir's friends and acquaintances that they say he controlled completely.

Shelley Rose Kelly, she was a school teacher.

He brought her in and next thing she knows she's running a surgical center.

Marissa Schoenbeck-Nelson basically she was his secretary.

He put her in charge of Golden State Pharmacy.

And she testified in open court about all this that, you know, she basically was running a pharmacy, but she had no idea about running pharmacy.

Ueda told her what to do and what to say.

And like that, he was able to run pharmacies, sleep study centers, MRI centers, and they were all in other people's names.

He would spend all his time on the phone every day, basically telling all these people how to run their individual companies.

We reached out to both Marissa Nelson and Shelly Rose Kelly, but they did not want to comment.

He was running, had a real estate empire, he had racing cars, he had dogs, he had horses, he was running all these things.

How does one person do all that?

Well, the testimony that came out was that people like Marissa, his assistants, they would get a list of things to do every morning and they would follow his instructions and then they would spend hours on the phone with him all day long.

He would hold their hand, tell them what to do.

Why would he do it?

What on earth would possess one man to do something so extreme, spend all his time doing it?

When prosecutors finally put a number to the size of the fraud, it's gigantic.

$150 million.

And you know, it's easy, in the audacity of this alleged empire of fraud, to forget all the people whose lives were upended or destroyed in its wake.

Just like Jenny Malone and Kim Pope from episode 3, so many of the victims that prosecutors found had unnecessary and multiple surgeries and were permanently damaged.

One victim named Mario Dominguez had three knee surgeries before Frontline told him that they had to replace his knee.

Mario did get his knee replaced, but he told prosecutors that even years later, he was still experiencing pain and swelling and was left with an eight-inch scar.

An expert doctor reviewed his case and found that Mario never needed surgery in the first place.

His story is just one of many.

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I lit the fuse and my life turns into everything it wasn't supposed to be.

He's going the distance.

He was the highest paid TV star of all time.

When it started to change, it was quick.

He kept saying, no, no, no, I'm in the hospital now, but next week I'll be ready for the show.

Now, Charlie's sober.

He's going to tell you the truth.

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I think we're past that, Charlie.

We're past that, yeah.

Somebody call action.

AKA Charlie Sheen, only on Netflix, September 10th.

The grand jury indictments came down in February, 2015, and until September, they remained secret.

During this time, the LA District Attorney's Office was getting ready, identifying bank accounts and other assets, locating their suspects, getting Munier's international warrant filed.

So then, they could pounce, arrest people, freeze assets, shut the fraud down.

But it didn't quite work like that.

When Frontline collapsed, there was hundreds of millions of dollars in receivers.

What new business is that?

This is an undercover agent speaking with Paul Turley, Munir's main business partner at the time.

Turley is explaining to the agent that as the heat was coming down on Frontline, they were already moving assets into a new business.

So he's running it from doing whatever he's doing from Lebanon

and UAI is still involved with that

as an owner.

Well,

we're both involved silently.

Anyway, out of the ashes, I rebuilt the business.

How did you do that?

I'm just getting.

If there's a will, there's a way, huh?

But I'm still against the plot.

By who?

By your way.

On September 14th, 2015, law enforcement fanned out across Southern California.

They arrested nine people, including Paul Turley and Kelly Supark.

On September 15th, the Los Angeles County District Attorney issued a press release, quote, 15 indicted in $150 million insurance fraud and patient scam conspiracy.

Munir was called the mastermind of fraud.

He was charged with conspiracy to commit insurance fraud, billing fraud, crimes, capping, which is illegal patient referrals, money laundering, and he was charged with aggravated mayhem.

The press release also said that Munir had been arrested in Germany and was awaiting extradition.

But he wasn't.

Like so many times before, he mysteriously escaped and his real whereabouts were unknown.

Big cases like this are not easy.

Even though the charges were announced in 2015, the litigation had begun years earlier.

The litigation started almost immediately in 2011, 10, 2011.

The original warrant that found the boxes that kicked off the fraud investigation was part of the Juliana Redding murder investigation.

Suddenly, all these very expensive lawyers were showing up, arguing in court.

So every little step that we tried to take, the lawyers would successfully get it bogged down in litigation.

After the indictments, there were teams of lawyers supporting each of the named defendants.

Prosecutors say Munir, out of reach in Lebanon, was the mastermind of that too.

Now the lawyers were saying, I represent this person, I represent that person, but we eventually argued to the court that

almost all of them were being paid by Ueda.

Despite the grand jury indictments, the initial judge was skeptical of the charges, especially the aggravated mayhem charge, the one that brought the possibility of life in prison for all those charged in the conspiracy.

And that was one of the first things that got challenged.

It sounds like something out of a Batman movie.

What it means is someone who shows, quote, extreme indifference to the physical or psychological well-being of another person intentionally causes permanent disability or disfigurement of another human being.

Prosecutors argued that the botched surgeries were aggravated mayhem.

And the rulings, like in all trials, went back and forth.

But to outsiders, it sure looked like the defense was winning.

Many of the initial charges, including those aggravated mayhem charges, were dropped by the judge.

Not enough evidence.

So the DAs then re-filed with a different judge.

The interesting thing about Ueda was Ueda was not prosecuted by the anti-fraud people in LA.

This is Jim Fisher, an attorney who specializes in workers' comp fraud, formerly with the California Department of Industrial Relations.

He was prosecuted by organized crime.

I always thought it was peculiar.

I spoke to one of the prosecutors.

This is Lance Lamont from adjustercom.net.

Lance not only followed and reported on the entirety of the Juliana Redding murder trial, but she also followed these new fraud charges.

We were sitting outside the courtroom one day, and we were sitting on the bench, and I just started talking to her and very nice woman and

she just said to me, Lon,

we're from the gang unit.

We worked on gang cases.

They had no experience with this kind of white collar crime.

And so they were making mistakes.

Prosecutor Dean Mathai says, no, it was the right team.

If anything, they were just outgunned.

There was high-powered lawyers on the defense side.

There were four or five lawyers just representing Paul Turley.

Munier's main business partner at the time.

So that was bigger than our whole prosecution team right there.

And then you multiply that by each of these defendants had either small law firms or one or two lawyers representing them.

And after literally years of legal back and forth, there were some results.

A lot of plea deals happened.

I'd say several.

Not a whole lot, but several.

Of the 15 indicted, two were on the land, Munir and one of his assistants.

One of the indicted was released.

Dr.

David Johnson, who I've mentioned, had advanced terminal cancer.

He's since passed away.

Eight pleaded guilty, most in return for testimony explaining exactly how the fraud worked, their own roles, and the roles of others.

Many of those pleas did involve jail time.

Paul Turley went to jail for 25 months.

He was Ueda's partner, Marissa Schoenbeck-Nelson.

She was a main player for Dr.

Ueda, was like a right-hand woman.

For some years,

she took a plea deal.

And Terry Luke, who was his accountant, He took a plea deal.

Paul Turley eventually pleaded out.

He's still awaiting final sentencing.

Peter Nelson, the physician assistant who prosecutors alleged did all those botched surgeries, he took a plea deal too.

He served two years of jail time.

Four defendants, including Kelly Sue Park, got off much easier.

Okay, here was the huge debacle that was terrible.

Kelly Supark,

Ronnie Case, and Tatiana Torres-Arnold.

Tatiana Torres-Arnold was one of Ueda's lawyers.

Those three got let go.

They got their cases dismissed because

the district attorney missed the deadline for their preliminary hearing.

It was prosecutorial incompetence.

Not quite, says Dean Mathai.

There was intense wrangling over a long-standing precedent that allowed prosecutors to group the defendants together together for pre-trial litigation.

But very expensive lawyers argued to an appeals court that that tradition should not stand.

And they won.

The court dismissed the charges against Kelly Sue Park and three others.

Dayon was shocked.

He appealed to the California Supreme Court and was denied.

Dayon says, they could have refiled the charges against Kelly and the others, but they were almost six years in at this point.

She'd already served seven months in jail for crimes that he says usually end in probation, and he wasn't even sure the judge would let them.

So Kelly Sue Park and three others walked free.

How did that make you feel when that happened?

Terrible.

Terrible.

It was devastating.

I still feel terrible about it.

I think what people need to realize is

it wasn't a dismissal based on the facts that were alleged.

It was a dismissal based on a procedural error.

So many people in Juliana Redding's friends, family, and her circle were heartbroken

to see Kelly Park walk free.

Is there anything that you would like to say to them?

Well, what I would say personally is I spent my whole career fighting for victims of crime, especially violent crime.

And so I understand

the heartbreak that they felt upon the acquittal of the murder case.

We didn't get complete justice against everybody, but we did get justice and we told the story.

I think the world can now look at it and see it for what it is.

So

I think we have a lot to be proud of in that regard.

And again, it wasn't perfect, but

it rarely is.

And that was the end.

Until it wasn't.

One of the first pieces of evidence that we found was a bill that was submitted to an insurance company for treatment by a doctor on a specific date.

Well, that doctor on that date was in jail in L.A.

So it was impossible that he could have performed this service.

You think taking down one $150 million scam can stop these guys?

Stick around.

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When the grand jury indictments came down in LA, it didn't stop the fraud.

It just changed it.

Hi, my name is Matt Murray.

I'm a prosecutor in Riverside County.

Erica Moll here.

another prosecutor with Riverside County.

When Frontline Medical made headlines in LA, Matt and Erica saw saw something strange start happening in their jurisdiction, Riverside County, right next door.

When the Los Angeles indictments came down and all of that started really to go, Ueda essentially gave field promotions to the people who hadn't been arrested in L.A.

Another company, Blue Oak Medical, suddenly started billing insane amounts, seeming to closely follow Frontline Medical's playbook.

You knew when people disappeared, i.e.

got arrested, then all of a sudden they started using, utilizing the name or Blue Oak, and they started changing the paperwork.

We had a bunch of employees tell us, yeah, I worked for Frontline and then I worked for Blue Oak.

But Erica and Matt say with Blue Oak, the scheme evolved.

Instead of a sprawling empire, all sides of that wheel of fortune we talked about, Blue Oak was focused on pharmaceuticals.

New brand, fresh start, different strategy.

Let's go.

For the most part, the main offices generally were the same.

Basically, one day it was Frontline, and the next day it was Blue Oak, and basically everything else was the same.

Here's how their Riverside prosecutors described the new scam.

The nutshell is that Blue Oak was trying to move as many legitimately injured people as possible through their clinics in order to submit what we think is fraudulent bills for the exact same medication that the person in control of Blue Oak was also in control of making the medication.

The key here, prosecutors say, was that the company was manufacturing new drugs out of inexpensive old drugs.

For example, you take a drug that's normally a $10 pill and you make it a cream or drinkable.

Since that new drug doesn't technically exist in the insurance billing system, you can kind of bill whatever you want for it.

Say $1,500.

It's not outrageous for a prescription drug to cost $1,500 a month.

And since the insurance companies are fielding so many billing requests every day,

probably

that'll just go through.

So then you bill it for $1,500 or whatever.

So if you prescribe it to, you know, Joe Schmo

three times, right, times 10,000 patients,

how much money is that?

I mean, 1,500 times three is $4,500 times $10,000 is

$45 million.

Matt and Erica found a data set showing that 80 to 90 percent of Blue Oaks patients, regardless of what they were being seen for, were receiving the same four medications.

The exact same cocktail of four medications that were all being, for the most part, they're being manufactured by the same specialized pharmacy that it turns out was also being controlled by the same people.

Sound familiar?

So in that situation, we said, look, if, you know, if 85% of your patients are getting the same medications,

no matter what their injury is, and those patients aren't even getting them in the mail, then yes, we argued that is fraud.

And the man behind it all, they allege, was Munir Ueda.

At the time Ueda was out of the country, he had been out of the country for several years.

How do you think he was directing all of this to happen?

Well, there was a significant amount of witness testimony that he was making a lot of phone calls and sending a lot of emails and doing a lot of WhatsApp.

So from wherever he was, he was pretty much working remotely before that was a thing.

Erica and Matt presented all their evidence to the Riverside County Criminal Grand Jury, which after hearing six weeks of testimony, indicted eight people on January 17th, 2019, accusing them of operating an international conspiracy to defraud the California workers' compensation system of more than $123 million.

which, you know, isn't $150 million, but give them a few more months, I guess.

It was eight total people across two different indictments.

And the way that the grand jury approved the indictments was they alleged that Munir Ueda was the leader of this conspiracy.

Seven of those indicted pled guilty.

Several went to prison for many years.

Others were put on probation and or agreed to cooperate and testify.

Everyone except Ueda, their cases have been closed.

No one at this point is still in custody.

While I'd like to tell you that there are currently no known remnants of Munir's empire, I can't.

When I asked Matt and Erica, they simply answered they don't know.

An arrest warrant for Munir remains active.

Is Ueda still making money in California?

I don't know.

I don't know.

That's not a no.

You're right.

Next time.

On doctor's orders.

I believe that Ueda is a very dangerous dangerous individual and he's very vindictive.

You just need to be careful when you're dealing around him and the people that he was affiliated with.

He came after her.

He has all this money, she has none, and it got so bad she couldn't keep affording to go back to court.

So she settled and she pays him every month.

Do you see that?

That is Kadri.

That's Kadri.

That's Kadri.

Standing there in the entrance.

Of course, that's 100% her.

100% it's her.

Wait, I'll take a note.

That's in episode 6, Fear and Loathing.

The season finale of Doctor's Orders.

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Doctor's Orders is produced by Western Sound for Sony Music Entertainment's The Binge.

The executive producer and host is me, Benedair.

The executive producer for The Binge is Jonathan Hirsch.

Doctor's Orders was written and produced by Nada Salem.

It was edited by Ben Adair.

Lila Hassan is our fact-checker.

Legal review by Davis Wright-Tremaine, LLP.

Michael Rayfield is the mix engineer.

Next up, the season finale of Doctor's Orders, episode six: Fear and Loathing.

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