Local gynecologist Jason Helliwell, already on probation by the state medical board for negligent patient care and sex with patients, now faces criminal allegations of billing fraud.
Helliwell and two others were charged Sept. 4 in a 31-count criminal complaint alleging a fraudulent medical billing scheme, according to the complaint filed by the Kern County District Attorney’s Office.
The complaint alleges that Helliwell, 47, conspired with Brandon Williams, 40, a sales representative for Irvine-based Exceltox toxicology lab, and Tamara Head, 53, owner of Rosedale Medical Billing Solution, to charge insurance companies for medically unnecessary treatment. The alleged fraud in the complaint dates back to 2010 and occurred as recently as 2016.
The schemes alleged in the DA’s complaint and investigative reports involve Helliwell ordering unnecessary blood and urine tests for patients for which Head is accused of fraudulently charging insurance companies. Helliwell received kickbacks from Williams, whose lab performed some of the testing, for the samples.
Reports state that Helliwell would collect urine samples from patients for lead and mercury testing and would “surreptitiously” order additional testing for illicit drugs without the patient’s knowledge.
Helliwell was given $20 to $25 per patient sample by the toxicology lab, former employees told an investigator, and the lab also paid for a personal medical assistant for Helliwell, according to reports.
Helliwell also ordered testing on an in-house blood allergy machine for patients who didn’t complain of allergy symptoms, the reports said.
Emails obtained between Helliwell and Head indicated the two worked together to bill insurance companies for services not provided to patients, to bill under other doctor’s names and to manipulate billing to receive higher reimbursements, the reports said.
The discovery was made as part of a joint investigation with the California Department of Insurance, according to Kern County Deputy District Attorney Joseph Kinzel.
Helliwell did not return a call to his office Friday seeking comment.
Helliwell faces 28 charges, including 14 counts of making false claims for health benefits, 10 counts of grand theft, two counts of conspiring to commit a crime, and two other counts of fraudulent activity. He turned himself into the Kern County Sheriff’s Office on Sept. 9, Kinzel said, and records show he posted $300,000 bail. He is due to be arraigned on Sept. 23.
Williams faces 16 charges, including five counts of making false claims for health benefits, five counts of grand theft, two counts for conspiring to commit a crime and four other counts related to insurance fraud. He posted bail of $175,000 and is due in court on Sept. 19.
Head, who faces four felony counts of false claims for health benefits, has posted $50,000 bail and is due in court for arraignment on Sept. 16.
In July 2018, Helliwell, who has an office on Brimhall Road, was placed on 42 months of probation by the state medical board after it investigated allegations of gross negligence and sexual misconduct.
Among other things, the gynecologist — who also practiced plastic surgery — was alleged to have performed breast augmentation surgery on two women who suffered serious complications.
In one case, the patient’s implant ruptured when Helliwell tried to replace it. Helliwell told the woman he didn’t have a replacement at his office so he sutured the incision closed and didn’t place a surgical drain, according to the accusation filed by the board.
Her symptoms worsened, and she was eventually admitted to an emergency room with sepsis, a potentially life-threatening complication.
As part of his probation, Helliwell is prohibited from practicing cosmetic surgery, with a few exceptions such as liposuction, must attend an ethics course and have a third party present when he consults, examines or treats women patients in the office, among other things, according to the settlement.