Medical groups clash over insurance coverage of herbal medicine


By Lee Hyo-jin

A pilot program rolled out by the government to include several types of herbal medicine in treatments covered by national health insurance was welcomed by practitioners of traditional Korean medicine. It, however, immediately provoked backlash from Western medical doctors.

As the government has plans to expand the coverage for more herbal medicine in the future following the progress of the trial program, the mixed reactions of the two medical groups may deepen into another dispute.

Under the pilot program, which started on Nov. 20, patients at traditional Korean medicine clinics who are prescribed treatments for menstrual pain, facial paralysis, or the aftereffects of cerebrovascular diseases, pay only half of the fee for the herbal medicine, as the rest is covered by state insurance.

The three-year test run is aimed at reducing the financial burden of patients and establishing a verified system to ensure the safety and effectiveness of herbal medicine, according to the Ministry of Health and Welfare.

Around 8,700 clinics providing traditional Korean medicine treatments across the country ― approximately 62 percent of the total ― have agreed to participate in the program.

Why Western medical doctors oppose

The announcement was immediately met with strong backlash from the Korea Medical Association (KMA), the largest Western medical doctors’ group in the country with more than 130,000 members. The association strongly condemned the government’s decision through a press release, calling it a “nationwide clinical trial using unverified medicine.”

They argued that easing public access to traditional Korean medicine and related herbal therapy will pose a risk to people’s health as they claim the safety of the treatments have not been adequately verified and there is no scientific evidence for their efficacy.

The association also pointed out that the program may lead to poor quality of herbal medicine, due to a shortage of certified herbal medication dispensaries and lenient control over them. While most small traditional Korean medicine clinics have own dispensaries, some large ones have outside dispensaries make the medicine.

“There are only five outside herbal medication dispensaries in the country certified by the government. This means that those five facilities will be preparing all the herbal medicines for over 8,700 clinics during the pilot program period,” KMA member Kim Gyo-woong said at a press conference, Nov. 23.

“The mass production system may lead to failure in quality control and safety issues, and considering the current lax control over dispensaries, the system may lead to illicit manufacturing of drugs,” he added.

In addition, the KMA stressed that the health authorities should focus more on the unresolved issues surrounding the side effects of traditional medicine.

More than half of medical disputes reported in relation to traditional medicine treatments were about herbal medicine, followed by Chuna manual therapy, acupuncture, and skin care, the association said, citing recent data from the Korea Consumer Agency.

“The government must immediately retract the policy which only puts public safety at risk, and launch a full investigation on all herbal dispensaries and prohibit the operation

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Does Health Insurance Cover Concierge Medicine?

Does health insurance cover concierge medicine? Are there strategies for getting the most out of your health insurance with respect to concierge medicine?

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The answers are: sometimes, and yes.

How Concierge Medicine Works

Concierge medicine is a heath care model in which a patient pays a fee – monthly, biannually or annually – directly to their doctor for the practice’s services. Under this model, consumers have access to their doctor or another physician in the practice whenever they want. Patients can make same-day appointments with little or no waiting.

This framework is similar to an arrangement of a client who keeps an attorney on retainer. Such clients can obtain legal services whenever they need them and don’t pay by the hour or case.

Concierge Medicine Costs

As for costs, the annual fee to subscribe to most concierge medicine practices ranges between $1,200 and $3,000, according to conciergemedicinetoday.org. Some high-end concierge medicine practices that provide services to well-off patients can cost tens of thousands of dollars a year, experts say.

Most concierge medical practices don’t take health insurance.

Here is the breakdown of payment options that concierge medicine practices accept, according to conciergemedicinetoday.org:

  • Cash only, 51%
  • Medicare or some insurance, 29%
  • Medicare but no HMO or PPO plans, 14%
  • Insurance but no Medicare, 6%

What Health Insurance Does and Does Not Cover

Here are the ways you can use health insurance for concierge medicine:

Gallery: 7 common recurring bills you can renegotiate (Mediafeed)

Medicare or some insurance. If you have Medicare or other health insurance, you can join a concierge medical practice, but you’ll have to pay the membership fee yourself. Regarding Medicare, a concierge medical practice “can’t include additional charges for items or services that Medicare usually covers unless Medicare won’t pay for the item or service,” according to Medicare.gov. In those situations, your physician must give you a written notice, known as an “Advance Beneficiary Notice of Noncoverage,” listing the services and reasons why Medicare may not pay. In such situations, a concierge practice may seek to impose additional fees for services not covered by Medicare, says Michael Seavers, the program lead in Healthcare Informatics at Harrisburg University of Science and Technology in Harrisburg, Pennsylvania. He notes that Medicare isn’t only used by older people. Individuals under age 65 with certain medical conditions, like renal failure, may also qualify for Medicare.

Similarly, if you have private health insurance, you must pay the fee yourself to become a patient in a concierge practice, says Dr. Amna Husain, a pediatrician and the founder of Pure Direct Pediatrics. That’s a concierge practice in Marlboro, New Jersey. “This fee will include the normal care you received from a non-concierge doctor with the added personal medical amenities the concierge practice offers,” she says.

You may be able to use Medicare or other health insurance to pay for items and services the concierge practice doesn’t provide, which can include:

  • Prescription medications.
  • Lab work.
  • Imaging.
  • Emergency department visits and hospitalizations.

Doctors who accept

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Does Health Insurance Cover Concierge Medicine? |U.S. News

Does health insurance cover concierge medicine? Are there strategies for getting the most out of your health insurance with respect to concierge medicine?

(Getty Images)

The answers are: sometimes, and yes.

How Concierge Medicine Works

Concierge medicine is a heath care model in which a patient pays a fee – monthly, biannually or annually – directly to their doctor for the practice’s services. Under this model, consumers have access to their doctor or another physician in the practice whenever they want. Patients can make same-day appointments with little or no waiting.

This framework is similar to an arrangement of a client who keeps an attorney on retainer. Such clients can obtain legal services whenever they need them and don’t pay by the hour or case.

Concierge Medicine Costs

As for costs, the annual fee to subscribe to most concierge medicine practices ranges between $1,200 and $3,000, according to conciergemedicinetoday.org. Some high-end concierge medicine practices that provide services to well-off patients can cost tens of thousands of dollars a year, experts say.

Here is the breakdown of payment options that concierge medicine practices accept, according to conciergemedicinetoday.org:

  • Cash only, 51%
  • Medicare or some insurance, 29%
  • Medicare but no HMO or PPO plans, 14%
  • Insurance but no Medicare, 6%

What Health Insurance Does and Does Not Cover

Here are the ways you can use health insurance for concierge medicine:

Medicare or some insurance. If you have Medicare or other health insurance, you can join a concierge medical practice, but you’ll have to pay the membership fee yourself. Regarding Medicare, a concierge medical practice “can’t include additional charges for items or services that Medicare usually covers unless Medicare won’t pay for the item or service,” according to Medicare.gov. In those situations, your physician must give you a written notice, known as an “Advance Beneficiary Notice of Noncoverage,” listing the services and reasons why Medicare may not pay. In such situations, a concierge practice may seek to impose additional fees for services not covered by Medicare, says Michael Seavers, the program lead in Healthcare Informatics at Harrisburg University of Science and Technology in Harrisburg, Pennsylvania. He notes that Medicare isn’t only used by older people. Individuals under age 65 with certain medical conditions, like renal failure, may also qualify for Medicare.

Similarly, if you have private health insurance, you must pay the fee yourself to become a patient in a concierge practice, says Dr. Amna Husain, a pediatrician and the founder of Pure Direct Pediatrics. That’s a concierge practice in Marlboro, New Jersey. “This fee will include the normal care you received from a non-concierge doctor with the added personal medical amenities the concierge practice offers,” she says.

You may be able to use Medicare or other health insurance to pay for items and services the concierge practice doesn’t provide, which can include:

  • Prescription medications.
  • Lab work.
  • Imaging.
  • Emergency department visits and hospitalizations.

Doctors who accept assignment can’t charge you extra for Medicare-covered services. (In the context of Medicare, “assignment” means your health

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Census Bureau: Young adults make up the largest share of those without health insurance

Young adults ages 19 to 34 have the highest uninsured health care rates in the country, according to census data — and Nicholas Williams hopes not to enter into that category.

He’s anxious, though. That’s because Williams will turn 26 next month, making him ineligible to remain on his parents’ health insurance plan under Affordable Care Act regulations.

“Twenty-six is the end of the road for me,” Williams said, referring to his current ACA plan. “I’m definitely nervous. … You’re cut off. I’ll be on my own.”

Before implementation of the ACA in 2010, health insurers set the age limit, which varied.

Williams, who lives with his family in East Islip, is frantically job hunting, with multiple interviews lined up, he said. Williams said he has a degree in social studies from St. Francis College and is interested in a job in customer service.

His health insurance needs are not far from his mind, he added, noting he is a Type 1 diabetic, something he said he’s been since he was 15.

“I’m on an insulin pump, and I also have a blood glucose monitoring system that tracks my blood sugar every five minutes. These devices make my life easier. It helps me manage my diabetes,” said Williams, who has worked part time and in temporary jobs that didn’t offer insurance. The cost “is manageable with insurance. I can’t imagine how much that would cost without insurance.”

According to the 2019 American Community Survey from the U.S. Census Bureau released Oct. 26, people ages 19 to 34 were the largest share of uninsured of any age group in the United States, at 15.6%, 0.4 percentage points higher than in 2018. That compares with 5.7% for those under 19, 11.3% for adults ages 35 to 64, and 0.8% for individuals 65 and older in 2019.

And the uninsured share of 26-year-olds was the highest among any single-year age, at 18.3%, which was 3.6 percentage points higher than the uninsured rate for 25-year-olds, the bureau said. Twenty-seven-year-olds had the next-highest uninsured rate, at 17.5%, in 2019.

The census bureau report said, “All adults may receive coverage through their employer, through public coverage or through purchase on the health care marketplace. However, young adults may be less likely to purchase health insurance coverage, and therefore more likely to be uninsured than other age groups.”

Daniel Lloyd, 34, founder and president of Minority Millennials, a grassroots nonprofit that works to represent minorities and millennials in policies, said health insurance coverage is on the minds of many in his group.

“A lot of members are focused on entrepreneurship, and many stay with jobs only because of health insurance,” Lloyd said. “So that impedes their desire to establish their own businesses.”

Lloyd, who also works for the Babylon Industrial Development Agency, recalled how a similar

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Younger Americans more likely to lose health insurance during pandemic

Roughly 3 out of 10 younger Americans say their health insurance coverage has been affected by the ongoing Covid-19 pandemic, according to a recent survey from TransUnion. 

About 33% of Gen Z (defined here as those born during 1995 or after) and 29% of millennials (those born between 1980-1994) had their health insurance impacted by the pandemic, including losing coverage, according to a survey TransUnion Healthcare conducted last month of more than 3,000 people who visited a hospital, health-care clinic, doctor’s office or health-care organization in the last year. 

Only about 12% of baby boomers experienced an impact because of Covid-19.

Beyond losing health-care coverage, about half of Americans say the current state of the economy has affected how they seek medical care, TransUnion’s survey finds. Within that, a higher percentage of Gen Zers and millennials reported a difference. 

Yet overall out-of-pocket cost trends have not changed dramatically, TransUnion finds. The average consumer spent about $485 on emergency room visits and $5,002 on inpatient care this year, which is a decrease of 7% and 5%, respectively, from last year.

More from Invest in You:
Author shares what investors should be doing during pandemic
‘Don’t leave money on the table’: 7 things to consider during open enrollment this year
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That may be due to fewer Americans seeking care. About 44% of employed Americans have put off medical care during the pandemic, according to a Willis Towers Watson survey released Wednesday. Of those that deferred care, 61% said it was because of Covid-19 fears and 42% cited cost concerns. 

Additionally, 47% of Americans have used virtual care services in place of in-person appointments this year — almost three times more than last year (17%), Wills Towers Watson finds. 

An average telehealth visit costs about $79, compared with about $146 for an office visit, according to a research paper published in May. But while telehealth could increase access and potentially replace an expensive urgent care visit with a virtual assessment, these appointments typically led to additional medical use, the researchers found. Only about 12% of telemedicine visits completely replaced an in-person provider visit, which could increase out-of-pocket costs overall. 

However, many times, telemedicine visits may be provided for free by your employer or your insurer, making it a “smart thing” to look into using before heading into the doctor’s office, says Tracy Watts, a senior consultant with Mercer.

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Fighting A High Medical Bill Takes Tenacity And Health Insurance Know-How : Shots

When Tiffany Qiu found herself on the hook for her usual 30% Blue Shield of California coinsurance after the hospital quoted 20%, she pushed back.

Shelby Knowles for KHN


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Shelby Knowles for KHN

When Tiffany Qiu found herself on the hook for her usual 30% Blue Shield of California coinsurance after the hospital quoted 20%, she pushed back.

Shelby Knowles for KHN

When Tiffany Qiu heard how much her surgery was going to cost her, she was sure the hospital’s financial department had made a mistake. Qiu already knew from a breast cancer scare earlier that year that her plan required a 30% coinsurance payment on operations, so she pressed the person on the phone several times to make sure she had heard correctly: Her coinsurance payment would be only 20% if she had the procedure at Palomar Medical Center in Poway, California, about 38 miles south of where Qiu lives.

“I was kind of in doubt, so I called them a second time,” said Qiu. “They gave me the exact same amount.”

Qiu had been diagnosed with uterine polyps, a benign condition that was making her periods heavier and more unpredictable. Her OB-GYN proposed removing them but said it was safe to wait. Qiu said that she asked about the possibility of doing it in the doctor’s office under local anesthesia to make the procedure cheaper, but that her doctor rebuffed her suggestion.

Because Qiu thought she was getting a deal on her usual 30% share of the bill, she decided to go ahead with the polyp removal on Nov. 5, 2019. As she sat in the waiting room filling out forms, staffers let her know she needed to pay in full before the surgery.

Unease set in. The hospital asked for the 20% coinsurance — $1,656.10 — that she had been quoted over the phone, but Qiu hadn’t been told she needed to pay on the day of the procedure. As she handed over her credit card, she confirmed one more time that this would be her total patient responsibility, barring complications.

The surgery was over in less than 30 minutes, and she walked out of the hospital with her husband, feeling perfectly fine.

Then the bill came.

Patient: Tiffany Qiu is a 49-year-old real estate agent and mother of two who lives in Temecula, California. Her family of four is covered by a Blue Shield of California policy that she and her husband purchased on the marketplace. Last year, they paid a $1,455 monthly premium, with an individual annual $1,850 deductible and an individual out-of-pocket maximum of $7,550.

Total Bill: Palomar Health billed Blue Shield $22,219.64 for the polyp removal, which the insurer negotiated down to $8,576.79. Blue Shield paid $5,769.72 and stated in an explanation of benefits document that Qiu was responsible for a $334.32 deductible and $2,472.75 coinsurance.

Because Qiu had already paid $1,873.20 on the day of surgery, the hospital billed her an additional $933.87, which meant Qiu was on

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50,000 children in Louisiana are without health insurance, the largest increase in a decade | Health care/Hospitals

Roughly 11,000 children in Louisiana lost their health insurance last year, the largest single-year drop in over a decade and an alarming reversal of years of progress getting kids covered.

About 50,000 children, or 4.4% of children in Louisiana, were uninsured in the state in 2019, according to an analysis of U.S. Census data by the Louisiana Budget Project, compared to 39,000 children who lacked health insurance in 2018. In 2016, the number of uninsured children was even lower, at 36,000.

The data in Louisiana mirror a nationwide trend that experts fear will worsen amid job losses and an unstable economy due to the coronavirus.



What contributes to Louisiana's high maternal mortality rate? The distance to care, research says

22 of Louisiana’s 64 parishes have no hospital offering obstetric care, birth center, OB/GYN or certified nurse-midwives 

“This reflected 2019, which was a year in which we had record low unemployment and a decade of strong economic growth,” said Stacey Roussel, policy director for the Louisiana Budget Project and author of the report. “Still, we were seeing the uninsured rate for children rising across the country as well as here in Louisiana.”

“It also means a record increase in the number of families without insurance for their children as we were going into the largest public health emergency we’ve seen in our generation,” she added.

Access to health care is critical for young brains and bodies, according to researchers and medical experts.

In the first few years of life, over 80% of brain development takes place and the foundation is laid for growth of major body systems.

Interventions are most effective when doctors can spot conditions at a young age before they become a bigger issue.

“Preventative care is the hallmark of pediatric care,” said Dr. Ryan Pasternak, an adolescent medicine specialist and associate professor at LSU Health New Orleans School of Medicine. “Our goal is not only to identify and treat acute and chronic illnesses, but also to address and identify lifelong illnesses.”

Even short gaps in care can allow things to slip through. Pasternak said he saw a young patient this month who lost Medicaid and put off care for seven months. When the patient regained coverage, it was a two and a half hour visit.

“There were just a plethora of issues that had not been addressed,” Pasternak said.

Boy born 22 weeks into mother’s pregnancy

It’s not yet clear exactly why Louisiana’s number of uninsured children has grown so much in a year.

In 2016, Louisiana expanded Medicaid to include those making up to 138% of the federal poverty level, or about $36,000 for a family of four as of 2020. By April 2019, the expansion provided coverage to more than 500,000 additional people.

But in May of last year, Medicaid enrollment dipped after wage checks that automatically kicked off people appearing to make too much money to qualify, dropping by about 50,000 enrollees by the of 2019. But in January, enrollment started to climb again, with 550,000 people covered by the expansion as of Sept. 2020. 

Providers searching

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Health Insurance Companies Working the System

Health Insurance Companies Working the System

PR Newswire

HUNTINGTON BEACH, Calif., Oct. 24, 2020

HUNTINGTON BEACH, Calif., Oct. 24, 2020 /PRNewswire/ — Many Californians are familiar with health insurance companies like Anthem Blue Cross, Blue Shield, Healthnet, Cigna or Aetna. We pay them a premium each month and expect that when we have a claim, they would do their part and cover us by paying our physicians and medical facilities. Although these are large companies, with many subscribers, COAST Surgery Center discovers that when they pay out their claims, they pay peanuts. How do they get away with that? Coast Surgery Center reveals their inside secret.

Coast Surgery Center (PRNewsfoto/Coast Surgery Center)
Coast Surgery Center (PRNewsfoto/Coast Surgery Center)

Since California law allows health insurers 40 days to accept or deny a claim, then allows them to notify patients every additional 30 days if they need more time, this allows for a loophole with no real deadline. So these insurers create a special department, which some call PPR (Pre-payment Plan Review), to intentionally delay payments by sending out general denial letters.  These letters provide auto-generated reasons like “incorrectly billed, missing signatures, missing documentation, or missing medical records,” in order to buy them time. They would give patients, doctors, and facilities the run-around and give excuses that may not even be relevant to the claim.

These large insurance companies pay lobbyists to help create laws that allow them loopholes to be able to get away with cheating their customers. Customers then purchase insurance policies that don’t even cover them when they need it. When customers get frustrated and demand the insurance to pay or want to ring the alarm, the insurance company then pays, but pays Medicare rate, instead of paying the Usual Customary Reasonable (UCR) or (RC) rates as they really should be. So medical providers and facilities get nearly nothing. This doesn’t make any sense when insurance premiums increase annually, and coverage keep decreasing.

California tax payers including patients, doctors, and facilities fund the Department of Insurance and the Department of Managed Healthcare (DMHC) so that they can ensure consumers of their healthcare rights and to protect consumers from being cheated. Yet these departments have either turned a blind eye towards these insurance companies or are not aware of their tactics. These Departments should be protecting consumers and investigate these insurance payout processes because they are working the system and using the loophole to scam customers of millions of dollars in premiums and paying out next to nothing or not at all. So instead of protecting the health insurance companies and letting them work the system, the Dept of Insurance and DMHC should be protecting patients.

If you are a patient, doctor or facility that have received notices from your insurance company or from a Pre-payment Plan Review department and have been struggling to get your claims paid, call COAST Surgery Center at 855-263-9968 and share with us your struggles.

Cision
Cision

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Mira Mesa dentist sentenced to 6 years in custody for $866K insurance fraud scheme

A Mira Mesa dentist was sentenced Wednesday to six years in custody and ordered her to pay more than $405,000 in restitution for fraudulently billing 10 insurance companies for hundreds of root canals she did not perform, authorities said.

April Rose Ambrosio, 59, pleaded guilty earlier this year to three counts of insurance fraud as part of a four-year scheme in which she billed the insurance companies $866,700, according to prosecutors and the state insurance commissioner.

Authorities said she was paid $405,633 by the insurance companies. San Diego Superior Court Judge Daniel Goldstein ordered Ambrosio to pay back that money.

She was ordered to serve a split sentence, meaning she will spend three years in county jail and three years on mandatory supervision in the community. California law changed in 2011 to allow some non-violent offenders to serve their prison terms in jail — a situation often described in court as “local prison.”

In September 2019, a judge ordered Ambrosio to stop practicing dentistry. State records show that’s when her license, which was issued in 1990, was suspended.

Authorities said Ambrosio falsely claimed to have performed 800 root canals on 100 patients between 2014 and 2018, even though she lacked the specialized training required to perform root canals.

In some instances, the people she claimed to have performed root canals for had never set foot in her office. In another instance, she billed an insurance company $61,700 for 110 root canals, all of which she claimed to perform on a family of four over just a three-month period in 2016.

“Her deception involved billing for work on days her office was closed, or she was noted as being on vacation,” county prosecutors said in a news release. “In some instances, Ambrosio billed for root canals on non-existent or missing teeth, or she double billed for teeth she previously claimed to have performed root canals on.”

San Diego County District Attorney Summer Stephan said the way that Ambrosio “bilked the system” was “astounding.”

“Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums,” Stephan said in a news release.

Ambrosio’s attorney, Kerry Armstrong, said his client “is extremely remorseful” and ready to begin her sentence next week.

“By all accounts, she was a fantastic dentist to her patients,” Armstrong wrote in an email Wednesday night. “And while she possibly will never get to practice dentistry again, she hopes to work in a field where she can help people once she serves her sentence and regains employment again.”

California Department of Insurance personnel investigated Ambrosio for more than two years and worked with the insurance fraud division of the District Attorney’s Office to prosecute the case.

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Dentist who stole $866K through insurance fraud gets 6 years in prison

SAN DIEGO (CNS) – A former Mira Mesa dentist who bilked insurance companies out of hundreds of thousands of dollars by submitting claims for procedures she never performed, including hundreds of supposed root canals, has been sentenced to six years in state prison, the San Diego County District Attorney’s Office announced Wednesday.

April Rose Ambrosio, 59, pleaded guilty to three counts of insurance fraud earlier this year for fraudulently billing insurance companies for $866,700, for which she received more than $400,000 from 10 insurance companies, according to prosecutors.

The DA’s Office said Ambrosio falsely claimed she performed 800 root canals on 100 patients, despite not having specialized training as an endodontist to perform such procedures.

Ambrosio was sentenced earlier this month, and in addition to a six-year prison term, was ordered to pay $405,633 in restitution. Her license to practice dentistry was also suspended last year, a few months after she was charged.

Prosecutors say the fraud occurred between 2014 and 2018.

During that time, Ambrosio billed for work she said occurred on days her office was closed and billed for more than 100 root canals during a three- month period, all of which were supposedly performed for a family of four, according to the DA’s Office. She also billed for root canals on teeth patients didn’t have or double billed for teeth she previously said she performed root canals on, the DA’s Office said.

“The way this defendant bilked the system is astounding,” District Attorney Summer Stephan said. “Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums.”

Ambrosio’s case was investigated over the course of two years by the California Department of Insurance and the San Diego County District Attorney’s Office.

“This medical provider abused the trust placed in her by fraudulently billing for procedures she never performed and was never trained to perform,” California Insurance Commissioner Ricardo Lara said. “Her illegal actions cost California consumers through higher insurance premiums and erodes the trust consumers hold for honest providers in the dentistry field.”

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