Nicholas Moore, 33, of North Myrtle Beach, South Carolina, has pleaded guilty to conspiracy to commit health care fraud and wire fraud. He admitted helping submit $199 million in fraudulent claims to insurance companies. He is the one defendant in the Los Angeles takedown announced October 22 whom the Justice Department describes as having pleaded guilty.
What Moore admitted
Moore managed certain facilities controlled by Nathan and David Young and served as a nominal owner and director of them, the Justice Department says. A nominal owner is a person whose name is on the ownership papers.
His plea was to a superseding information, a charging document that replaced the earlier one. The release does not give the date of the plea or the court, and it lists no sentencing date. It also does not name the insurance companies or say whether any were Medicare or Medi-Cal.
Claims like these reach people as lines on a statement. Medicare.gov tells enrollees to compare the dates and services on their own calendar with those statements, to set up a secure online account that shows Original Medicare claims as soon as they are processed, and to call the provider about any charge that looks wrong.
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The same Medicare.gov guidance warns against accepting money or gifts in exchange for free medical care. In this case, the Justice Department alleges recruits were drawn in with flights, cash, housing and gifts. The offers that move a person into a program can be the first sign the program is billing someone else.
Moore’s $199 million sits inside a larger case. The Justice Department says the Youngs and two Texas recruiters, Honey and Cody Phipps, ran a scheme that billed private insurance companies over $1.6 billion. By division, Moore’s claims are roughly one-eighth of that total.
Fifteen defendants, and only one plea described
By the release’s own listing, ten of the 15 defendants were indicted, four were charged by information and one by criminal complaint. Moore is one of the four charged by information. Eight of the 15 were arrested, six due in downtown Los Angeles and two in Texas.
Steven Mladinich, 38, of Newport Beach, was also charged by information, and the release says his facts were admitted in a plea agreement. It does not say he has pleaded guilty. Prosecutors allege he took kickbacks of $150,000 to $250,000 for referring addicted patients to a licensed rehab facility, including a $33,000 check.
Patients allegedly had to stay 21 days before the payments were triggered, and many left on day 21 against medical advice. The payments were disguised as marketing services under a sham contract.
The other defendants face charges only. They include a cardiothoracic surgeon and a chiropractor accused in an atherectomy scheme, three people accused in hospice cases, two doctors accused of taking genetic testing kickbacks, a Medi-Cal pharmacy defendant and a doctor accused of selling drug samples.
What a guilty plea settles, and what it leaves open
A guilty plea is an admission of the charge, not a sentence. Moore’s punishment comes at sentencing, and the announcement gives no date. The release ties his conduct to the scheme the Youngs and the Phipps are accused of running, and it says co-conspirators trafficked patients to sham treatment facilities. The Youngs and the Phipps are presumed innocent until proven guilty.
Assistant Attorney General Colin M. McDonald said the department is “coming for you,” adding that “the data will lead us to wherever you are.” First Assistant U.S. Attorney Bill Essayli of the Central District of California called it “especially egregious” when health care professionals “who pledged to do no harm” commit fraud.
Miranda L. Bennett, HHS-OIG’s acting deputy inspector general for investigations, said the takedown shows that those who exploit patients and steal from federal programs will be held accountable. Darren Lian of IRS Criminal Investigation in Los Angeles said: “Healthcare fraud is not a victimless crime.”
The strike force program behind the announcement has charged more than 6,200 defendants since 2007, the release says, and those defendants billed federal health care programs and private insurers over $45 billion in total. Against the whole announcement’s more than $1.8 billion in claims, Moore’s $199 million is about 11 percent, a share worked out here by division. Against the program’s $45 billion since 2007, it is well under one percent.
Moore’s case was worked by agents from three federal agencies, including the Drug Enforcement Administration, and is being prosecuted by Trial Attorneys Siobhan M. Namazi and Erika V. Suhr of the Fraud Division with Assistant U.S. Attorney Haoxiaohan Cai.
The Justice Department’s Health Care Fraud Section says it works through nine strike forces and uses data analysts alongside prosecutors to spot new schemes. A patient who spots treatment on an insurance statement that never happened can take it to HHS-OIG’s fraud reporting page, or call the department’s tip line at 1-800-HHS-TIPS.
Is that insurance charge real, and what if a claim is denied?
Insurers in this case were billed $199 million for treatment prosecutors say was not needed or not given. A person on the receiving end sees only a statement line or a denial letter, and a missed appeal window can turn a wrongful denial into a bill.
The Medicare Cost & Coverage Protection Kit lays out the prior-authorization appeal steps and includes a medication and cost tracker for logging care and charges as they happen. Part 4, Beat a Denial, covers fighting a coverage denial step by step.
Get the denial-appeal steps and charge-tracking kit for Medicare →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
Warren Cohen is a finance writer based in Phoenix, Arizona, covering personal finance topics including credit, banking, and beginner investing. He earned his degree in business administration from Arizona State University and began his career working in consumer finance, where he gained direct experience with lending and credit systems. He now writes for personal finance websites and fintech platforms, focusing on clear, practical content that helps readers make informed financial decisions.
