Federal authorities are hunting a Filipina scammer who is believed to be the mastermind of one of the biggest health care rackets in California.
Susan Bendigo-Lim, 41, originally from Davao City is believed by US authorities to have fled to the Philippines to evade liability for the $17-million Medi-Cal fraud.
A mother of two teens, Bendigo-Lim stands accused of five felony counts in the US District Court, Central District of California for health care fraud and for aiding, abetting and causing the commission of such fraud.
According to investigators, the scam started in 2003 and continued until 2007 to become the largest Medi-Cal fraud case in California history.
Court documents showed the scheme, allegedly hatched by registered nurses Bendigo-Lim and Priscilla Villabroza, involved the hiring of unlicensed workers to perform services to disabled Medi-Cal patients.
Authorities said they then billed Medi-Cal as if skilled, licensed nurses had done the work through Santa Fe Springs, California-based company, Medcare Plus Home Health Providers, and its sister companies, Excel Plus and Unicare.
According to the US Attorney’s Office, these unlicensed nurses visited patients at home and at school and provided nursing services.
Authorities said that all sorts of improprieties happened at Medcare, Excel Plus and Unicare ranging from falsifying documents to impersonating a Licensed Vocational Nurse (LVN).
Court documents showed that Bendigo coached some of the unlicensed workers to lie about their licensing, identity, and qualifications by representing themselves as licensed vocational nurses (LVNs).
On July 9, 2009, federal and state authorities arrested 20 of the 42 defendants named in the indictment. Most of the people arrested either had little or no nursing training.
Soon, however, some parents and patients began to see lapses that eventually unmasked the fake nurses.
In one case, investigators said, a “nurse” was unable to replace a tracheotomy tube that had fallen out of a young patient’s neck.
And in another case, a worker fled a medical situation when she could not provide care.
Bendigo-Lim finished her nursing course in Cebu City, moved to Southern California and made it big through the companies she managed.
Docketed as criminal case 2:09 cr-00148-UA, USA vs. Bendigo aka Susan Lim, the indictment was made in February 2009 yet.
It was only recently that the OIG decided to put a face on healthcare fraudsters, which included Bendigo-Lim.
Her suspected accomplice, Villabroza, has since pleaded guilty to five counts of health care fraud and faces up to 50 years in prison.
Reports suggested that the wanted nurse had fled and set up several residences in the Philippines, including one in Cebu City, to evade arrest and eventual extradition to the United States.