MEDI-CAL MILESTONE REACHED COURT-ORDERED FRAUD FINES TOP $100 MILLION.

Byline: Troy Anderson Staff Writer

The amount of court-ordered restitution and fines raised as a result of Medi-Cal fraud cases has topped $100 million since 1999 after a Woodland Hills woman was sentenced to three years in prison and ordered to pay $2.98 million in restitution.

``Medi-Cal fraud hurts us all, from the taxpayers who foot the bill for health care for California's poorest citizens, to the Medi-Cal patients, who face reduced services and limited eligibility every time the state is forced to cut funding because of budget deficits,'' Attorney General Bill Lockyer said Wednesday. ``Far too often, we see greedy criminals who use unwitting patients to fraudulently line their own pockets, hampering our efforts as a society to help those most in need.''

In September, Lockyer obtained the longest criminal sentence for Medi- Cal fraud in California history. Surinder Singh Panshi, 54, of South Orange, N.J., was sentenced to 16 years in prison and ordered to pay $2.5 million in restitution to the state and $124,000 in back taxes to the Franchise Tax Board.

The most recent sentence, which pushed the monetary recovery for Medi-Cal fraud over the $100 million mark, was obtained against Mila Sigal, 51, of Woodland Hills.

Sigal owned and operated L&M Diamond Jewelry Optical in West Hollywood, from 1993 to 2001. According to the complaint, she and her husband, David Sigal, 56, bilked Medi-Cal of $2.98 million by filing false claims for eyeglasses they said were replacements for Medi-Cal patients whose eyeglasses were lost, stolen or destroyed.

The investigation revealed the Sigals used personal information about 6,341 unwitting Medi-Cal beneficiaries to fraudulently bill Medi-Cal for 59,574 pairs of unnecessary eyeglasses from 1995 to 2001.

The investigation began in March 2001, when the Department of Health Services notified the Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse that responses to a survey sent to Medi-Cal beneficiaries indicated several had not received the eyeglasses that were billed in their name by L&M Diamond Jewelry.

The bureau's investigation uncovered numerous cases in which the Sigals billed Medi-Cal for dozens of eyeglasses in a little more than a year, but the patients whose names were used said they had only received a couple of pairs during that period.

L&M Diamond Jewelry Optical shut down in early June 2001, shortly after the bureau served search warrants at the business and the Sigals' residence. Criminal charges were filed later that month, charging the Sigals with one count of conspiracy, one count of grand theft of more than $2.5 million and 62 counts of presenting false Medi-Cal claims. Prior to trial, both defendants pleaded guilty to one count of presenting false Medi-Cal claims and one count of grand theft of more than $50,000.

Due to David Sigal's limited role, he was sentenced in June 2002 to five years of probation and 100 hours of community service. Los Angeles Superior Court Judge David M. Mintz on Friday sentenced Mila Sigal to three years in state prison and ordered her to pay $2.88 million in restitution, noting she previously had paid $100,000 in restitution. David Sigal was ordered jointly liable for the $2.88 million restitution.

Troy Anderson, [phone]

troy.anderson(at)dailynews.com