The Binge Cases: Scary Terri - Doctor Billions | 3. Rat’s Nest

Episode Date: October 15, 2026

It’s not just Drobot. As the FBI caught on to the breathtaking scope of the fraud, they expanded their investigations all over Southern California. And they started turning one doctor after another into wire-wearing informants. Want the full story? Binge every episode of Doctor Billions ad-free now by subscribing to The Binge+. You’ll unlock over 60 true crime series instantly, get early access to drops on the first of every month, and hear exclusive bonus episodes. Search for the channel on Apple Podcasts or head to GetTheBinge.com. For behind-the-scenes details, join our free newsletter at Patreon.com/TheBinge. Doctor Billions is a production of Sony Music Entertainment and Western Sound. Follow @sonypodcasts and discover more at sonymusic.com/podcasts. Learn more about your ad choices at podcastchoices.com/adchoices. The Binge — feed your true crime obsession. Learn more about your ad choices. Visit podcastchoices.com/adchoices

One day last year, police entered a mansion in L.A. County and discovered the couple that lived there had almost two dozen children, nearly every one of them born through surrogates. But those surrogates had been deceived. I started crying. I was like, what the heck did I just get myself into? I'm Ava Kaufman. The Journey is a new series from In the Dark and The New Yorker. Find it now in the In the Dark podcast feed. Listen to every episode of Dr. Billions ad-free right now when you subscribe to The Binge. You'll hear the entire series before anyone else get exclusive bonus episodes and unlock more than 60 other true crime podcasts.

Just head to The Binge channel on Apple Podcasts and tap subscribe, or visit getthebinge.com to listen wherever you are. The Binge, feed your true crime obsession. How do you turn a doctor into a rat? Sorcery, maybe a magic word or two. In order to bring down a billion-dollar fraud, the FBI was going to need to think outside the usual white-collar crime playbook. I think part of what we were shocked at was just the scale of the entire thing. This is Special Agent John Hobbin.

He's been with DeBurro 22 years. We knew it was big, but once you get... get through it, it just seems, it's bigger than you can even imagine. You know, when you're looking at billions, it's just a number that we can conceive of when you're talking about money. The FBI launched not one but two investigations. One in L.A., headed up by Special Agent Hobbin, and one in San Diego, headed up by former Special Agent Jeff Horner.

These guys, all of them were very paranoid. This is Jeff. They would meet out in the ocean. They would get on surfboards and go out into the ocean so they could talk. They would turn off their phones, leave your phone in a lot. Faraday bag if you want to meet with me, all those different things. The agents knew they couldn't just send in an undercover to try to bribe a doctor or buy or sell them a patient.

We need someone who's sort of vetted already with the people we're targeting. And so introducing an undercover agent into a scenario like this doesn't necessarily make sense because they're new. Nobody trusts them. Who is this guy? He must be a cop. Exactly. So if you have some.

who's already committed fraud with them, they're a little bit more comfortable with them to be able to talk about the fraud they're doing and potentially engage in new fraud going forward. So how do you get a doctor, lawyer, or medical marketer to betray his co-conspirators and tell everything they know to the FBI? Turns out it's a four-step process.

Step one, get the dirt. We have recordings of you or we have checks or this person is said that you received a kickback. Step two, and this might be the trickiest step, make the approach. It's a calculated decision we have to make because if this person says no, they're on the phone telling all their network, hey, the FBI's out here investigating us, don't talk to anybody and it shuts us down.

So the dirt's got to be really good. But when, where? We showed up at doctor's offices. Obviously, it's a little weird for cops to show up. It kind of raises some red flags with the staff. And so we have some plausible stories of why we're there for some billing or something like that or another patient. And it gets us alone. Getting to their house is not necessarily a good answer either because there's family members there and things like that.

Step three, make the ask, which could also be read as threaten the daylights out of them. So we'll sit them down and say, here's the situation you're in right now. and for helping us out, maybe you can get a reduced sentence. We as the FBI agents, we're not allowed to promise anything as far as getting a reduced sentence. But what we can do is ensure that at sentencing, the judge has all of the information of the cooperation that they did. So we've met people at houses. We've met doctors at doctors offices. said, hey, here's the deal.

We have a search warrant ready right now that we're going to implement on your office right now with your entire staff. Everybody will know exactly what's going on, or we can wait and not do that if you will agree to work with us. Step four, roll the tape,

which is actually the new step one for all the other doctors, lawyers, and other people that this guy's about to mention. Ultimately, then they would give us the information. They either give them a search warrant or we do it, you know, sort of under the cover of darkness and we get what we need. But we can do it sort of in a way that keeps us a little bit more covert. And repeat, and repeat and repeat. Soon, the biggest workers' comp medical scam in California history would be riddled with rats.

I'm Benadere from Sony Music Entertainment and Western Sound. you're listening to Dr. Billions. This is episode three, rats nest. Twice every year, lawyers representing injured workers under California's workers' compensation program gather at an event called the California Applicant Attorney Association Conference. And that may be the most boring sentence in podcast history. But hang on, because the FBI had a problem. They knew about this ever-increasing.

fraud operation, pulling in more and more doctors across Southern California, but they didn't quite have the goods. So this conference, where lawyers all get together to go over the latest info about the workers' compensation system, it presented an opportunity. Not everybody there was a bad guy, certainly not, but all the bad guys would be there. So how do you tell one from the other? How do you get them all together and get them to give up the goods? It took a little creative thinking.

They're a very tight-night group. This is not something that, you know, people speak freely about on the phone. It's very relationship-driven. Former FBI Special Agent Jeff Horner got to thinking. What's the one thing these guys all have in common? I kind of thought to myself, well, what's the biggest weakness of an attorney? I thought to myself, well, attorneys love to talk, right? The FBI had learned from an informant in Los Angeles that there was this one lawyer in San Diego who seemed to be at one particular nexus of this giant web.

According to the LA informant, this guy was paying kickbacks to marketers who brought him injured workers and then receiving kickbacks from the medical providers that he referred the patients to. Essentially, me was buying and selling patients. They were treated like cattle in many ways. In January 2012, the big conference was taking place. place at the San Diego Sheraton Hotel and Marina. Jeff Horner got a big idea. What we decided to do was rent out a ballroom at the Sheraton Hotel Marina in San Diego, a nice hotel right there on the bay, and invite a whole bunch of our suspect doctors.

A very exclusive dinner. The best doctors and the best attorneys, an exclusive club, so to speak, again, so they kind of felt like they were special. And the lawyer they want as a target, his name was Sean O'Keeffe, they invited him to give the keynote. We thought that would be the best way because these doctors, we knew we had intel that they were involved in illegal activities. We had intel that Sean O'Keefe was. And so I thought, what better way to get them to start talking about that than have Sean O'Keefe get out in front of a ballroom of dirty doctors, many of whom he already had relationships with, encouraged them to give a person. presentation and have a question and answer center.

Female FBI agents cosplayed as pharmaceutical reps and worked the room. So if you can imagine the traditional pharmaceutical rep, right, they fit a certain profile, attractive female marketer with great personality, highly intelligent. And so we put five female FBI agents in the room, wire them up for recording devices, placed recording devices around the ballroom, and just sat back and let these doctors and attorney. talk about how much money they made doing all these bad things. We rented a room in the hotel, and pretty much the entire night, the undercover agents were coming back in, swapping, recording devices,

and it was quite an adventure. It was a lot of fun. It went better than anyone could have imagined. It's amazing. I mean, some of the things that these doctors would brag to the agents about, just trying to flirt or what have you. They just love to talk. I recall one hospital executive bragging about how the hospital was getting paid for putting the implants, the spinal implants, in these poor patients, and then taking them out because the implants were bad and then putting more implants in. And that really kind of shocked me. And Sean O'Keefe in particular, very intelligent, bright attorney, one of the top attorneys,

but you put him in front of an audience of doctors that he knows is dirty, and that's really kind of how things kicked off for us. The operation was so successful. A few years later, the FBI did it again. And very soon, all these doctors who'd made millions exploiting patient trust would be having trust issues of their own. By mid-2012, there was not one but two major FBI investigations into how doctors were illegally making money off workers' comp patients in Southern California.

And this was in addition to Bill Reynolds' parallel investigation with Marks'ansy. In L.A., the FBI had Operation Spinal Cap, which focused around Paul Randall, Michael Drobot, and spinal surgeries out of Pacific Hospital in Long Beach. The San Diego office called their investigation Operation Backlash, which focused on a huge web of marketers, doctors, and lawyers paying money for things like MRI referrals, toxicology, psych tests. Get it, spinal, cap, backlash. Interestingly enough, you know,

backlash is really kind of one word, but FBI undercover operations have to have two words, so I just kind of broke it apart, and we kept it as backlash. That's like a rule that they have to have two words? Yeah, I'm not sure. I was just told that it had to be two words, and so that's kind of what we went with.

Fun fact. Like Bill Reynolds, who was a. a former cop turned insurance investigator, former special agent Jeff Horner brought a special skill set to this investigation. He had a background investigating gangs in San Diego.

Then he went to work at the Security and Exchange Commission. When he returned to the FBI office in San Diego, he thought he'd be put back on gangs or maybe securities fraud. Something sexy. But instead, he was assigned to health care. Well,

yeah, traditionally health care fraud. It's very documented. intensive and they're very long cases, slow moving. But he was all, maybe we can do this difference. It was really quite fascinating because I was able to work health care fraud cases from a gang perspective, very heavy on recordings and informants and undercover operations, and then also leverage some of my experience working financial investigations. What Jeff Horner was seeing in San Diego and what FBI specials,

agent John Hobbin was seeing in Los Angeles was very different than your typical health care fraud, where you might have a single doctor radically overbilling or patients faking injuries for cash. What was happening here was extremely coordinated. You might even say organized. I think that's a very accurate description of how they work. It's amazing how integrated these organizations were, and in some cases even tied to organized crime. And the scams, as we heard last episode, were very well papered. High-priced lawyers drew up contracts to make everything seem legit.

Everyone from the administrators at the top to the doctors on down had a high degree of plausible deniability. And so if you can't get the subjects in their own words, they're very difficult cases to prove. And so for both FBI operations, backlash and spinal cap, informants were the beating heart of the investigations. After the exclusive dinner event, the FBI knew how the whole scam was working in San Diego, and it was a little different than what was going on in L.A.

In San Diego, independent operators would comb swap meats, restaurants, bars, parks, all the places they'd find Latino immigrant workers. These workers, who often had fewer legal protections, They were the targets. A man would approach, strike up a conversation, and ask, hey, you've been injured on the job lately? There might even be a wink, wink. Yes, they would give them a card with a 1-800 number,

and it would go to a call center, and those call centers were manned by operators who then would tell the injured worker, hey, you need to go see Sean O'Keefe. He's a great attorney. care of you. O'Keefe, who passed away since all this went down, he would get the call from the worker and say something along the lines of, there's a whole system here to help you. I'm going to take care of you, and you're going to get care, and you're going to get paid. What the worker didn't

know was that O'Keefe, all the medical companies and the doctors, were going to get really paid. And so these doctors just needed the patients, and they would do everything they could to get those patients. And if it meant referring somebody that came in from... for a sore right knee to get an MRI for a right knee, left knee, left ankle, right ankle, elbows, cervical spine, lumbar spine. Oh, by the way, you need a mouth guard. Oh, by the way, you need a sleep study. And oh, let's give you some of these topical pain relieving creams. Just because my knee's a little sore, you would suddenly have all those things. Yeah.

And then, when the care had run its course, O'Keefe had one more trick up his sleeve. because he was a lawyer. You receive this medical treatment and then when that treatment is done and you're essentially not cured but you're essentially brought back to be able to work again. The applicant attorney will sit down with the insurance

company and say, okay, well, thank you for paying the medical bills of this person but this person suffered pain and suffering and his knees never going to be the same his back's never going to be the same. So we're now going to settle that potential legal sued for his injuries.

The more money the doctor is made off the patient's care, the more money O'Keefe would go after in his lawsuits. Sean O'Keefe sits down across the attorneys for the insurance companies and say, by golly, my poor patient here got $50,000 worth of medical treatment. If you want to settle this, we're going to do three times that for a settlement. The settlement is more likely to be higher if there's a whole bunch of medical procedures that were referred. The money reigned down on everyone.

The doctors, patients, and Sean O'Keefe. It was astonishing how sophisticated. They monetized every aspect of an injured worker. From the point that they're injured, all the way through treatment and settlement. Using one of their sources in the L.A. investigation, the San Diego team introduced an undercover agent to O'Keefe, posing as a rep.

who wanted to bring spinal surgeries to Pacific Hospital in Long Beach. It was a slow role. They needed to make a relationship and then make an ask. As those relationships develop, as O'Keefe took our undercover agent around to meet doctors, and we started to kind of get our hooks into things. Eventually, they set up a meeting between the undercover and O'Keefe in Coronado, the super fancy part of San Diego, right on the ocean. That's where he lived. He had a couple of yachts.

He loved yacht racing. In fact, he was a judge for many large racing events throughout the world. And we met at a tiny little diner in Coronado. We paid him money in exchange for 10 patients that needed spinal surgeries. Was it like a briefcase full of cash? It was an envelope full of cash. It all happened on videotape. O'Keefe handed over the patient files.

The undercover gave him several thousand dollars. The patients were sold. for money. A short time later, they called O'Keeffe and said, hey, that was great. Let's do it again. Only this time, there was no envelope. It was almost kind of a rendition in that I pulled up the car right onto the sidewalk in front of the diner. John and another agent grabbed him. We threw him in the back of the car to arrest him, and we drove off to the FBI office. They'd gotten the dirt. They'd made the approach. Time to make the ask. Mr. O'Keefe was very cocky and very, you don't have anything on me.

Well, okay, then let's just threaten the daylights out of him. Put Mr. O'Keefe back in the car and drove him to the downtown federal holding facility, parked on the Sally Port, and he could hear all the people inside just kind of talking and cat-calling and making these noises to him. And here's this high-end attorney, very intelligent man, and he turned around and said, I want to cooperate. They drove straight to the U.S. Attorney's Office and signed him up. And then put him to work.

They started with a doctor named Stephen Riggler. Riggler was a chiropractor with three clinics in San Diego and nearby Calexico and Escondido. They set up a meeting between O'Keefe and Riggler. They'll discuss their business and the FBI will get on tape, dirt on a crooked dock. Special Agent Horner was in the parking lot at O'Keefe's office, sitting in his car. He saw Riggler drive up, park, and go inside. He waited. Dr. Riggler comes out after the meeting and everything's great.

And I see him run back into Chano Keeves' office. And I'm like, what's going on here? Special Agent Horner had a broken foot at the time. So he crawled out of the car and hobbled his way into the building toward the elevator. Because I'm concerned that there's a safety issue. I call for backup. up. Dr. Riggler is a very large individual. I want to say he's probably six four, six, five, 240, 250 pounds, and Sean O'Keefe is not that. He's kind of a small fellow. I barge into

Sean O'Keefe's office. Dr. Riggler's there yelling at Sean O'Keefe. Right after the meeting, O'Keefe had gotten a little excited. He texted Horner, just had a great meeting with Dr. Riggler. He gave up all the goods. It was awesome. I think we got him. But he sent it to Dr. Riggler instead of to me. And so... Oops, sorry, wrong window. Please ignore.

You know, I take charge of the situation, have Dr. Riggler sit down, and basically told him that Dr. Riggler, you're screwed. We've been meeting with you. We've been recording with you for a while. We know what you're doing. We know your connections to these doctors. And he sat down and he realized,

at that point, it was best for him to start to cooperate. Poof, just like that, Dr. Riggler became a rat. You know, it's funny, too, just as a side note, you spend a lot of time training these informants, right? Everything you say and do is being recorded. Try not to use profanity or don't make personal judgments or things like that. So you spend all this time training, and on the very first meeting, he sends it to the target.

Great recording. We got him. He's done. He's going to start working for us. Oops, sorry. Wrong chat. meant to send that to my wife. Oh, man.

The tapes these informants collected show a remarkably brazen scam. Wow. Yeah, I'm just here more like the enforcer than anything else. Yeah, you can see if these numbers, everyone's changing. Then also, I don't understand why.

Basically, a menu with prices attached. Only, it's not what you pay, it's what you get paid when you order different procedures from specific companies. Ultrasons, 10 bucks, x-raiser, 10 bucks, toxicology 75, companies 200. I'm assuming it would change based on... Toxology, okay. And then Sykes 100 MRIs. MRIs 25? I thought it was higher than that. It was 50 if we were to start working.

Okay. If we started doing that compound. That's something. No mention of patients, no thought about how much effort it takes a patient to show up to these procedures, maybe take time off work, get childcare, all the time it takes to get to and from. Only money on the mind. In L.A., Special Agent John Hobbin was up to his ears in contracts and financial statements. They were scrutinizing all the business arrangements between DROBOT, Pacific Hospital, and these doctors,

comparing them to bank records to make sure the quid pro quo. between money and surgeries was real and ongoing. So they would write a contract for $30,000 a month. And the doctors would get $60,000. Or in the next month, they would get $15,000. And the next one, they'd get 30. And they started to realize that at one point. And so they started amending the contracts.

And some contracts had three and four and five amendments to them. The first one was for $30,000. And when that surgeon started bringing a lot more patients, Now it's at $60,000 a month. And then it was $65,000 or $85,000, depending on how many patients they were bringing in. And he and his team started to notice something else, a new wrinkle to the fraud. In addition to the doctor billing for their surgery, the hospital billing for their part of providing the facility and the services there, there was a third bill that was getting submitted. And that was for the hardware implant.

they were being placed in the patients as part of the spinal fusion surgery. At the time, there was a regulation in place called the spinal pass-through law. This allowed a hospital doing a spinal surgery to get reimbursed for the full sticker price of whatever the spinal hardware cost. That's the screws, the rods,

the other pieces that stabilized the spine. What we uncovered was shell companies that were inflating these costs of the heart. hardware. So there were middlemen, so to speak, between the hardware manufacturer and the hospital. These middle companies were inflating the costs of the hardware a lot. And in one specific incident, one of those middlemen companies we discovered was a company owned by Drobot himself. Michael Drobot, the owner of Pacific Hospital. So then insurance would pay Pacific for their services that they rendered as part of the facility, and then they would also pay them for the

hardware that was used for the patient. At double, triple, sometimes even 10 times the actual cost. The surgeons are effectively forcing the patients to do their surgery at Pacific Hospital, and they have to tell them, well, it's because it's the best place for you. They can't say because I'm getting an extra $15,000 or $20,000 for going there. So you have, is the The surgery the right option is the place of surgery. The right option is the hardware that's getting implanted in you the right option. There's so many places in there for corruption of decisions made by these doctors and everyone else involved that has a duty to these patients. Operation spinal cap and operation backlash were in separate offices targeting separate sets of doctors, but they shared DNA.

Jeff Horner and John Hobbin were friends. So they shared info and other things. You know, sometimes I think, you know, FBI agents get very, they don't want to share their informants. They don't want to extend anything outside their case. One informant in particular was worth sharing, especially at the beginning. It was a guy whose work spanned all across Southern California. This was the informant who first leaked Sean O'Keeffe's name to the FBI. John was happy to make the intro to Jeff.

John and I are great friends. He's a super talented agent, super bright, and if it wasn't for him sharing Paul Randall with me as an informant very early on, our case never would have taken off. Paul Randall, the rat that started at all. The same guy who'd shown up at Marks or Sancy's door to kick his rat ass was spilling his guts to the FBI, recording conversations with Drobot and countless other doctors as they negotiated the biggest kickback skis. in medical history. And he was not only talking to the FBI, he was feeding Bill Reynolds information too. And while the FBI did know about those meetings, what they didn't know was that Bill Reynolds was talking to the press, and that was going to jeopardize the whole operation.

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It was very hard to miss. On Thursday, February 9th, 2012, on the front page of the Wall Street Journal, just below the lead article on Mitt Romney losing presidential primaries in Colorado, Minnesota, and Missouri, was this headline. In small California hospitals, the marketing of back surgery. And right below that, a close-up portrait of the FBI's most valuable informant, Paul Randall. The lead writer of the people,

piece, John Kerry You did not want to comment for our story, but Bill Reynolds confirmed that he and Marks or Sancy were talking at length with the paper, several months of calls and data sharing. And since Bill knew Paul Randall and New Paul liked to talk, Bill was very open with Carey you about the role this guy was playing. I'm just going to read a few choice quotes from the article. Quote, Mr. Randall, 52 years old, an entrepreneur with a collection of sports memorabilia and a yen for gambling, began his career as a hospital marketer in the mid-1990s after serving a stint in federal prison for racketeering, unquote.

Quote, after serving time in the Terminal Island Federal Correction Facility in Long Beach Harbor, Mr. Randall went into business with Michael D. Drobot, the owner of Pacific Hospital of Long Beach, unquote. And then this one. Quote, by last August, federal prosecutors had prepared a charge that, that if filed in court, would accuse him of conspiring to inflate the cost of spinal surgery hardware and use the proceeds to pay kickbacks to doctors to refer workers' compensation patients for surgeries. The article almost reads like a straight profile of Randall.

And if you're in business with the guy, you might just wonder, why hasn't that indictment been filed? Obviously, that's not good when your cooperator is on the front. page of the Wall Street Journal. Operation Spinal Cap lead agent John Hobbin. It effectively shut us down, and I thought our case was done. John could probably picture in his mind all the rats fleeing the sinking ship. I thought everybody would have shut down, it would have moved on, and figured that the jig is up.

We need to move on and find something else. And? It was quiet for a while, because everybody sort of went into hiding, because they were afraid that the big, bad government was. going to come and spoil all their plans. But when nothing happened, at least that they saw, then they kind of like stuck their head out and we're like, okay, it looks like the coast is clear. And what shocked me was how quickly everybody recovered

and went back to business as usual. Because it's so much money. You can't give that up. You can't give it up. Things did get a little tougher for Paul Randolph. but only a little. We had Paul Randall meeting with Lokesh Tantawaya at a sports club in La Jolla.

And Dr. Lokesh Tantawaya was so paranoid he would have Paul Randall stripped down and actually bend over and he checked his anus for recording devices. It was not up his butt that day. In April 2013, a little over a year after the Wall Street Journal article came out, the feds were ready to start making

moves, taking their investigation from the covert to the overt phase. Make it dramatic. I need some music. It's theme music. Drobat had two offices, one at Pacific Hospital in Long Beach and the other, a corporate office in Newport Beach in Orange County. It was Raiden Time. So we show up there, knock on the door, you know, 8 o'clock in the morning and myself and

80 of my closest friends decide that it's time to, to, to, take this case and move it forward. Do you have one of those battering rams and you're going through the door? I mean, we have them, but generally in the white collar cases, everybody's like, okay, we'll just open the door for you. It took all day. Then the next day, the group showed up at Pacific Hospital and raided it too. Soon, even Michael Drobot would begin cooperating with the feds,

giving them information that would, in turn, help both Operation Spinal Cap and Operation Backlash. But far away from these raids, far away from the newspaper headlines, far away from both FBI investigations, there was another man. His name was Robert Pereira, and he had a different view on everything that was going on at Pacific Hospital. I made a good living for a couple of years, but no matter how much I was being paid, I just couldn't stand by. Robert's job during these years was a representative for one of the companies providing hard, to some of the surgeons conducting these spinal surgeries. Many mornings, he would show up at Pacific Hospital

and set out the trays of hardware for that day's surgeries. He says some of that hardware was hiding a secret. There's just no excuse for it. I mean, postpone the surgery, source another vendor, figure something out. He says the rods and screws doctors were putting in patients' bodies were not medical grade, and they were not regulated by the FDA.

He says he saw them being manufactured on the down low at a nondescript machine shop in the California desert. These guys are going to have surgery tomorrow morning and these implants are going in their spine and they're bullshit. Every day, Robert delivered this hardware to operating rooms. He'd look up at the board of patients coming in. I'm looking at the surgery board for tomorrow going, these people are fucked.

There's five, six surgeries on the board, and these people are fucked. The kickbacks were just the beginning. That's on the next episode of Dr. Billions. Dr. Billions is produced by Western Sound for Sony Music Entertainment's The Binge. I'm your host, Benadair. I'm also the executive producer for Western Sound.

From Sony Music Entertainment, the executive producers are Jonathan Hirsch, and Catherine St. Louis. Dr. Billions was reported and produced by Dana Ballute. It was written by Dana Ballute and Benadair. Najeeb Amini is our fact-checker. Michael Rayfield is the mix engineer, music courtesy of North Figueroa Studios.

Legal by Sam Borenswig at Claris Law, P-L-L-C. Next up, episode four, Egot maniac Airlines.