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CA Department of Insurance

Healthcare company CEO arrested for insurance fraud

News: 2015 Press Release

For Release: November 3, 2015
Media Calls Only: 916-492-3566
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Healthcare company CEO arrested for insurance fraud
Prosthetic maker forges documents to collect payment after patient dies

LOS ANGELES, Calif. - Peter Lira, 53, CEO of Am-Pro Prosthetics & Orthotics in Whittier, was arrested on three felony counts of insurance fraud for allegedly billing Anthem Blue Cross for a $170,000 prosthetic arm after Lira was notified the patient had died. 

Suspecting fraud, Anthem referred the claim to the Department of Insurance for investigation. Detectives found evidence that Lira allegedly submitted fraudulent invoices and forged the deceased patient's signature on the delivery receipt to collect payment for manufacturing a prosthetic arm even though the patient has died.  

"Losses from health insurance fraud are larger than all other types of insurance fraud," said Commissioner Dave Jones. "Fraud committed by healthcare providers is particularly egregious and contributes to increased health insurance costs when insurers pass their losses along to consumers through higher premiums."

Lira was arrested on Friday and booked into Men's Central Jail in Los Angeles. He faces five years in prison, if convicted on all counts. This case is being prosecuted by the Los Angeles County District Attorney's Office.

Media Notes:

The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 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 $469 million in claims and premiums. Please visit the Department of Insurance website at Non-media inquiries should be directed to the Consumer Hotline at 800.927.4357. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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