Pain Docs Plead Guilty to $45 Million Healthcare Fraud

A pair of Texas pain management doctors have pleaded guilty to healthcare fraud charges, admitting to bilking insurance companies out of $45 million.

Drs. Desi Barroga, 51, and Deno Barroga, 51, pleaded guilty Tuesday to one count each of conspiracy to commit healthcare fraud before U.S. Magistrate Judge Rebecca Rutherford.

According to court documents, the twin brothers conspired to defraud Blue Cross Blue Shield, Cigna, and United Healthcare by submitting claims for corticosteroid injections that were never administered.

As part of the scheme, the Barrogas required patients to submit to monthly office visits, which allowed them to continue receiving highly addictive Schedule II controlled substances, including hydrocodone, oxycodone, and morphine. They then billed the patients’ insurance companies for expensive services they never provided.

The defendants reported performing as many as 80 corticosteroid injections per patient per visit, but in reality, the majority of these injections were never administered. In some cases, the doctors would simply place a needle on the patient’s body without piercing the skin to mimic giving an injection.

The Barrogas also created fake medical records, which were often cut and pasted or cloned from patient to patient with little to no variation. They instructed patients to include false statements in the records, further perpetuating the scam.

Under the terms of their plea agreement, the brothers must immediately surrender their DEA registrations and forfeit their medical licenses at least 14 days prior to sentencing. They also agreed to joint and several restitution in an amount to be determined by the court.

The U.S. Department of Labor’s Office of Inspector General, the U.S. Department of Labor’s Employee Benefits Security Administration, the U.S. Office of Personnel Management’s Office of the Inspector General, the Drug Enforcement Administration’s Dallas Field Division Diversion Group, and the Texas Department of Insurance – Fraud Unit – Austin and Fort Worth Field Offices conducted the investigation. Assistant U.S. Attorney Renee Hunter is prosecuting the case.

The brothers now face up to 10 years each in federal prison for their role in the scheme, which netted them at least $9 million in payments from the insurance companies.

The case serves as a stark reminder of the ongoing threat of healthcare fraud in the United States, with millions of dollars lost each year to scammers and con artists.