NICB Agents Receive Investigation of the Year Award

Courtesy: San Diego County DA

The National Health Care Anti-Fraud Association (NHCAA) recently presented its 2016 Investigation of the Year Award to NICB Supervisory Special Agent Tom Downey and Special Agent Malisa Trimble of the West Region. The Agents received the award for their “Operation Backlash” investigation, which resulted in the indictment of eight defendants in November of 2015, 13 defendants in January of 2016, and federal indictments against three individuals and four corporations.

“Operation Backlash” was an extensive 4-year multi-agency undercover operation initiated to combat entrenched corruption in the California Workers’ Compensation System (CWCS) private insurance program. The loss to CWCS was in excess of a half-billion dollars. The sheer scale of this fraud makes it one of the largest insurance bribery schemes in workers’ compensation ever uncovered in San Diego County.

The case aggressively targeted a vast web of multiple conspiracies involving doctors, attorneys, and chiropractors working with patient call centers, ancillary service providers, and medical marketers. The targets all paid and received several million dollars in illegal kickbacks.
To date, a total of 22 individuals and 10 corporations have been indicted and plea agreements have been secured with 6 individuals and 3 corporations tallying over $2.1 million in forfeitures. As a result of these actions, 13 criminal organizations have been disrupted and 3 criminal organizations have been dismantled.

SSA Tom Downey and SA Malisa Trimble with their NHCAA Investigation of the Year Award