San Jose, CA (WorkersCompensation.com) - A doctor and an unqualified medical interpreter were arraigned earlier this week on felony fraud charges for conspiring to bilk insurance companies out of thousands by billing for translation services that were illegal or non-existent.
In some cases, Gabriela Pacheco –46 of San Jose - simply substituted her unqualified family members to do the translations, which are required by state law to be done by a certified interpreter. In other cases, Pacheco billed companies for patients with Latino surnames for which she hadn't done any work at all. Dr.Tariq Mirza, 60, of Union City, helped organize the scam and received kickbacks, according to the charges.
Mirza and Pacheco were charged with conspiracy to commit workers' compensation billing fraud and unlawful kickbacks for patient referrals. If convicted, they face time in prison.
“There's a reason you have to be certified to do these translations,” prosecutor Julie Sousa said. “Injured workers are entitled to a standard level of care – which includes qualified interpreters to translate everything from their surgery risks to medication instructions.”
Mirza is the owner of Ariba Healthcare Group Inc., providing medical and chiropractic treatment with offices in San Jose and the greater Bay Area. The clinics primarily treat patients in the workers' compensation system. Pacheco is the owner of One World Interpreting Services, a San Jose company that provides Spanish translation services for medical providers.
The scam fell apart when the District Attorney's Bureau of Investigation initiated an investigation which revealed that defendant Pacheco was billing over 100 insurance companies, claims administrators and selfinsured employers despite being unqualified under the California Code of Regulations. The Bureau requested assistance from the Franchise Tax Board. An FTB agent examined thousands of records which uncovered over $100,000 of kickbacks from Pacheco to Mirza through payments made to third parties.
In 2017, DA investigators discovered that Mirza submitted written reports to at least six insurance companies falsely identifying Pacheco as a “licensed interpreter.” A search of Pacheco's home business revealed over a thousand patient files containing medical information, in violation of medical record privacy laws.
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