AILING FOREIGNERS A PAIN FOR COUNTY : ASSEMBLY PANEL TOLD OF MEDICAL FRAUD PROBLEMS.

Byline: David Bloom Daily News Staff Writer

Filipino stewardesses who fly to Los Angeles to give birth and wealthy Middle Easterners seeking free open-heart surgery are among those who fraudulently stick Los Angeles County taxpayers with their medical bills, officials told an Assembly panel Thursday.

Many overseas nationals have been prevented from getting free care by a new program at Los Angeles International Airport's customs lines and increased cooperation with U.S. embassies and immigration officials.

But county and state taxpayers still are paying millions of dollars annually because of conflicting laws, too few regulators, or sympathetic customs agents and eligibility workers willing to overlook rules for overseas visitors who arrive ill.

``There's almost an invitation to come over to California, the land of opportunity'' for free medical care, said Assemblyman Jan Goldsmith, R-Poway, chairman of the Assembly Subcommittee on Border Crime. ``If you're (a foreign national) in any other country in the world, you don't get care.''

The subcommittee held a daylong hearing at the county Hall of Administration in downtown Los Angeles, focusing on fraud by foreign citizens who seek expensive medical procedures that taxpayers finance either through indigent care write-offs or Medi-Cal.

Under state law, the county health care system is the provider of last resort to residents of the county and must provide health care for individuals who have no other way to secure that care.

Doctors and hospital administrators said foreign nationals take advantage of the system by claiming to be indigent county residents, then receive care - up to and including surgeries that cost hundreds of thousands of dollars - before the hospitals are able to fully check their eligibility or residency status.

Among the horror stories told by fraud investigators and county doctors:

A heart patient arriving at the county's Harbor/UCLA Medical Center in Torrance in a Rolls-Royce, but receiving free open-heart surgery because he claimed he was poor, said Dr. John Robertson, Harbor's former chief of thoracic and cardiovascular surgery.

An Iranian man who told Harbor doctors he ``heard on the radio in Tehran (Iran) if you need heart surgery, go to Harbor/UCLA in Los Angeles,'' Robertson said.

Filipino stewardesses, many of them related to prominent Philippines officials, repeatedly have used the valid work visas they have through their airlines jobs to fly into the country on maternity leave and have their babies born in U.S. hospitals, said Larry Malm, the region's chief investigator for the state Department of Health Services.

An Ethiopian man who arrived in the United States a month ago and was undergoing heart surgery at Harbor on Thursday, said Dr. Fritz Baumgartner, who succeeded Robertson as head of the hospital's thoracic and cardiovascular surgery.

``He almost certainly doesn't fill any requirement for residency,'' said Baumgartner of the Ethiopian, one of Harbor's 300 patients a year who undergo open-heart surgery. ``The word is out that Harbor/UCLA is a good way to get cheap medical care.''

Mexican nationals who arrive at county hospital waiting rooms seeking care, with maps in their pockets showing the route from Tijuana to the hospital, Robertson said.

``These are extreme examples, but people around the world are abusing our services,'' said Robertson, now chief of thoracic and cardiovascular surgery at St. John Medical Center in Santa Monica.

Doug Bagley, a county health administrator, said foreign patients at County/USC Medical Center in Boyle Heights hail from all over the world. Nearly 40 percent come from Mexico and Latin America and 37 percent from Asia, Bagley said. Additionally, 15 percent come from Europe.

``The source of the problem is worldwide in its nature, and just adds to the complexity of what to do from a policy standpoint,'' Bagley said.

A year-old state fraud-interdiction program at LAX and San Francisco International Airport flags likely incoming abusers and checks computer records to see if they already owe money for previous medical care, Malm said.

The ``Public Charge Lookout System'' relies on referrals by LAX customs officials of incoming passengers whose records and appearance show such tell-tale signs as frequent entries and serious medical problems, Malm said.

Those visitors are sent to a secondary investigation area at the airport, where their names are checked against computerized records of outstanding Medi-Cal bills.

More than 200 LAX visitors with unpaid bills have been caught, and forced to either pay up or go home, Malm said.

Even that program could be more successful, with changes in federal laws and more investigators, Malm said.

For instance, customs officials must process visitors within 45 minutes under federal law, a time crunch that leads some Immigration and Naturalization Service supervisors to let ailing visitors go through quickly, without a follow-up investigation, officials said.