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CA Department of Insurance

Doctor arrested for role in insurance fraud scheme

News: 2014 Press Release

For Release: October 27, 2014
Media Calls Only: 916-492-3566
Doctor arrested for role in insurance fraud scheme

OAKLAND, CA. - Alameda County District Attorney Nancy E. O'Malley announced today that a Castro Valley physician and surgeon, Douglas J. Abeles, M.D., surrendered on an arrest warrant obtained by the Alameda County District Attorney's Office for his role in an insurance fraud scheme occurring out of his East Bay business office. He has been charged with 31 felony offenses following an investigation that was conducted jointly by the Alameda County District Attorney's Office and the California Department of Insurance.

"Large insurance fraud schemes are often highly sophisticated," said District Attorney Nancy E. O'Malley. "This investigation required extensive and diligent investigative work, entailing the meticulous collection of evidence. I commend the Department of Insurance for its diligence in partnering with my Office on this investigation." 

The charges against Doctor Abeles and his office manager, Gabriela Cuevas, indicate that for several years he falsely and fraudulently billed insurance companies for medical services that were not provided. While Douglas Abeles, M.D., had an orthopedic medical practice in Castro Valley, Douglas J. Abeles M.D. & Associates, he also owned and operated at least four medically-related businesses from an office located at the Castro Valley-Hayward border. Gabriela Cuevas managed these businesses for Dr. Abeles. These businesses included drug testing urine analysis for medical offices that contracted with Dr. Abeles. It was through this business that the defendants allegedly fraudulently billed insurance companies for lab reports.

"This physician's systemic abuse of the medical services system inflates premiums for all Californians who eventually end up footing the bill for this type of fraud," said Insurance Commissioner Dave Jones. "Our detectives, investigators and law enforcement partners spend countless hours to root out those who abuse the insurance system for their own personal financial gain. The Alameda County DA's Office was an invaluable partner in moving this case forward."

Any medical professional or insurance company that believes it may have been a victim to this fraud is asked to contact the Alameda County District Attorney's Office at 510-383-8600.

Media Notes:

The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $289 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $394 million in claims and premiums. Please visit the Department of Insurance web site at Non-media inquiries should be directed to the Consumer Hotline at 800.927.HELP or 213.897.8921. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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