A longtime Santa Barbara physician has pleaded guilty to one count of conspiracy to commit health care fraud in a federal case.
Dr. Julie Taguchi, an oncologist who had been with the Sansum Clinic for 27 years, entered a plea deal on Jan. 24 for knowingly and willfully executing a scheme to defraud a health care benefit program affecting commerce from at least July 2018 until about April 2020, according to court documents obtained by Noozhawk.
Taguchi acted as a conspirator to Mark Schena, president of Arrayit, a Nevada corporation based in Northern California that describes itself as a “world leader in microarray technology empowering researchers and doctors in the life sciences, wellness and health care testing markets,” according to the court documents.
Taguchi was the laboratory director of Arrayit, and Schena has been charged with three counts of conspiracy in a larger case for submitting false and fraudulent allergy test claims to the Medicare program that were obtained by the payment of illegal kickbacks and bribes, were medically unnecessary and/or not provided as represented, according to court documents.
Schena and others made a handful of misrepresentations to potential investors about Arrayit’s allergy test sales, financial condition and its future prospects, according to a criminal complaint filed against Schena.
Altogether, Taguchi and others submitted nearly $250,000 in false claims that were obtained through the payments of bribes, were medically unnecessary, were ineligible for Medicare reimbursement and/or not provided as represented, according to the documents.
Taguchi resigned from Sansum’s Ridley-Tree Cancer Center right before entering the plea agreement so that the clinic was not affected, she told Noozhawk. She said Sansum was never involved in the fraud case allegations.
As part of the alleged conspiracy, Taguchi, Schena and others applied for and maintained various lab certifications from state and federal agencies that allowed Arrayit to conduct testing and submit claims to Medicare and other insurance plans.
The claims falsely certified that Taguchi held the appropriate qualifications to serve as the lab director of Arrayit and conduct the testing as Arrayit’s lab director, according to the court documents.
Taguchi provided her national provider number to Schena and others, which was used to submit the fraudulent claims for allergy testing on behalf of Arrayit for patients that Taguchi never saw or treated, according to federal court documents.
Additionally, when the novel coronavirus pandemic first started, Schena, Taguchi and others used it to expand the fraud conspiracy by bundling COVID-19 testing with Arrayit’s more expensive allergy testing, which does not identify or treat COVID-19, according to the court documents.
Taguchi allegedly ordered and caused others to order the bundled testing option, despite knowing that the allergy test was medically unnecessary and the COVID-19 test returned false positive results, indicating that a patient was positive for COVID-19 antibodies when in reality the positive results were because of past or present infections with non-COVID-19 coronavirus strains, according to the documents.
The conspirators concealed the scheme by entering into fake contracts and agreements that disguised the kickbacks and bribes as payments for lab director or other legitimate services, federal court documents allege.
Taguchi was accused of submitting the false claims, concealing the submission of the claims, and the receipt and transfer of the proceeds from the fraud to Medicare, and diverting the proceeds for personal use and benefit to further the conspiracy, according to the court documents.
Taguchi’s charge calls for forfeiting any personal or real property that was derived, directly or indirectly, from the proceeds of the fraud, which is included but not limited to a sum of $10,039.
When reached for comment, Taguchi said she was unable to discuss details of the case until the trial was over.
Taguchi is expected to serve as a witness in Schena’s trial, scheduled to begin on Nov. 30, therefore delaying her sentencing hearing until Feb. 28, 2022.
The trials and sentencing will be held at the U.S. District Court in the Northern District of California.
— Noozhawk staff writer Jade Martinez-Pogue can be reached at jmartinez-pogue@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.