Nov. 03--The chief executive of an Anaheim prosthetic limb manufacturer is facing insurance fraud charges for allegedly billing a patient's insurance for a prosthetic arm after being told the patient had died, the California Department of Insurance announced Tuesday.
Peter Lira, 53, of Am-Pro Prosthetics Orthotics, is suspected of billing Anthem Blue Cross for a $170,000 prosthetic arm for the deceased patient, officials said.
Nancy Kincaid, a spokeswoman for the California Department of Insurance, said Lira allegedly made the arm for a Los Angeles County public defender who died of cancer. After the man's death, Lira is believed to have changed the circumstances under which the arm was needed, claiming the man was still alive and needed the limb because of an industrial accident, Kincaid said.
Anthem suspected fraud and referred the claim to the Department of Insurance. Detectives with the department found evidence that Lira had submitted fraudulent invoices and forged the dead patient's signature on a delivery receipt for the arm, Kincaid said.
Calls to Am-Pro Prosthetics Orthotics offices in Anaheim and Whittier went unanswered Tuesday.
Lira faces three felony counts of insurance fraud, according to a felony complaint filed in Los Angeles County Superior Court. He is scheduled to be arraigned Nov. 18, said Greg Risling, a spokesman for the Los Angeles County district attorney's office.
Lira was booked on suspicion of insurance fraud and released following his arrest in late October. He faces up to five years in prison if convicted on all counts, the Department of Insurance said.
"Losses from health insurance fraud are larger than all other types of insurance fraud," California Insurance Commissioner Dave Jones said in a statement. "Fraud committed by healthcare [providers] is particularly egregious and contributes to increased health insurance costs when insurers pass their losses along to consumers through higher premiums."
Lira currently is serving probation on domestic violence charges, according to the Department of Insurance.
Am-Pro Prosthetics Orthotics has been operating for three decades, with a primary office in Anaheim and satellite offices in Whittier and Sherman Oaks, according to the company's Facebook page.
In 2011, the Whittier Daily News wrote about a 25-year-old Ricardo Zazueta of Whittier, a mechanic who built race cars, whose leg was severed after a nitrous-oxide tank exploded in his garage. One of Zazueta's friends turned to her uncle -- Lira -- who donated a $12,000 prosthetic leg, the newspaper said.
