County officials on Monday released the grand jury transcript and a 181-page indictment accusing a Newport Beach radiologist and three other defendants of nearly 900 charges in an alleged $17 million workers’ compensation fraud.
Dr. Sim Carlisle Hoffman, 59, of Newport Beach is a radiologist and owner of Advanced Professional Imaging, Advanced Management Services and Better Sleeping Medical Center in Buena Park.
Hoffman is charged with 592 felony counts of insurance fraud for BSMC, 291 felony counts of insurance fraud for API, and one felony count of aiding and abetting the unauthorized practice of medicine. If convicted, he faces a sentence ranging from two years up to 892 years and eight months in state prison.
“We need to end these types of medical fraud mills – STAT. Let’s end unethical doctors, unscrupulous dealings, and patients being treated like walking ATMs,” District Attorney Tony Rackauckas said. “We hope before people engage in these types of schemes, they ask themselves if this is worth 800 years in prison?”
Also included in the case are Dr. Thomas Michael Heric, 74, of Malibu, a neurologist who worked for Hoffman at BSMC, Beverly Jane Mitchell, 60, of Westlake Village, the insurance billing administrator for Hoffman’s businesses, and Louis Umberto Santillan, 44, of Chino Hills, who worked in collections at API.
“The magnitude of the fraud committed by these co-conspirators is reprehensible,” said Insurance Commissioner Dave Jones. “When medical providers conspire to defraud the California workers’ compensation insurance system, everybody loses, including the injured workers and the businesses that employ them.”
Mitchell faces the same charges and sentencing as Hoffman. Heric is charged with 296 counts of insurance fraud, one felony count of aiding and abetting the unauthorized practice of medicine. Santillan is charged with 141 felony counts of insurance fraud and faces up to 150 years.
Hoffman and his co-conspirators are accused of billing insurance companies for more expensive, unnecessary and falsified procedures. Hoffman is accused of fraudulently billing the City of Los Angeles and 19 insurance companies.
In 2001, the state board disciplined Hoffman for excessive billing and giving a patient unnecessary radiology treatments
All four defendants made bail but are expected to be back in court for arraignment on June 22 in Santa Ana. The hearing on the revocation of Hoffman and Heric’s medical licenses will be heard at the same time.
