The office manager of a Southern California imaging center that paid referring physicians for patient referrals has been sentenced to five years in prison. The sentencing marks the end of a state and federal investigation into healthcare fraud dubbed Operation Backlash.
Gonzalo Paredes received the prison sentence on June 14 after he was convicted of 51 felony counts of healthcare fraud in a jury trial in November 2018. Paredes was the office manager of Advanced Radiology, which was involved in the "largest healthcare insurance fraud scheme in the history of San Diego County," according to the San Diego County District Attorney's office.
Advanced Radiology was owned by radiologist Dr. Ronald Grusd, who previously was convicted of 39 federal counts of paying illegal kickbacks for patient referrals. Grusd was sentenced to 10 years in prison last year.
According to evidence presented at trial, Grusd and Paredes paid kickbacks to a high-volume chiropractic office in San Diego County in exchange for patient referrals to Advanced Radiology. The center performed MRI scans and other procedures on the patients and then billed workers' compensation insurance companies.
Investigators claim that Advanced Radiology paid more than $225,000 in kickbacks and billed insurance companies more than $5 million over the course of the scheme. As office manager, Paredes helped negotiate kickback arrangements, handled day-to-day interactions, processed covert invoices for illegal payments, and prepared checks for kickback payments.
The conviction of Paredes marks the end of the state and federal investigation into Advanced Radiology, which had been dubbed Operation Backlash. In addition to Grusd and Paredes, other defendants in the case have received prison sentences.
"We have closed this chapter on the largest healthcare fraud case in San Diego's history thanks to the hard work of our investigators and the District Attorney's office," said Insurance Commissioner Ricardo Lara. "Paredes will be held accountable for his crimes and should serve as a warning to others that we will do everything within our power to bring justice to those who put cash before patient care."
