The owner of a Temecula substance abuse treatment facility, who allegedly submitted dozens of false claims to a health insurance company and collected more than $250,000 before the scheme was uncovered, pleaded not guilty Wednesday to 30 counts of insurance fraud.
David Leo Johnson, 55, is accused of ripping off Health Net over a 15-month span ending in May 2016.
Johnson was arraigned before Riverside County Superior Court Judge David Gunn, who scheduled a felony settlement conference for June 4 and set the defendant’s bail at $270,000.
Johnson is being held at the Byrd Detention Center in Murrieta.
According to the District Attorney’s Office, the defendant ran Southern California Detox Treatment & Recovery and allegedly engaged in a scheme that involved 90 Health Net policies whose holders were either bogus or unaware of how their information was being utilized.
Prosecutors allege that Johnson falsified claims and double-billed Health Net on multiple occasions.
Johnson allegedly made initial premium payments on 62 percent of the policies involved in the scheme and used his business address as the policyholders’ place of residence.
“Interviews with clients showed that they did not submit the applications for their health insurance policies and were not aware of how the coverage was obtained,” according to the D.A.’s office. “When interviewed, the clients also advised that Johnson did not charge them any of the required patient costs, including deductibles and co-payments.”
Health Net requires that policyholders meet 50 percent of their deductible before out-of-network payments for substance abuse counseling can be made, and according to the D.A.’s office, Johnson was circumventing that qualifier by making it appear on submissions as if the patients had paid up.
The defendant has no documented prior felony convictions in Riverside County.