Orange County’s COVID-19 testing partner during the pandemic, 360 Clinic, was double and — at least once — triple billing for services carried out under a county contract, according to an internal investigation report reviewed by LAist.

The county report also states that a $523,650 payment that 360 Clinic issued to the county went missing for over three years. A company spokesperson told LAist its chief financial officer delivered a cashier’s check to the county in December 2020. LAist reviewed a copy of that check provided by a company spokesperson. The county says it never received it.

Both sides agree that it was never cashed.

In all, the company took home more than $3 million in county taxpayer money, according to a county healthcare agency spokesperson, and likely many times that in private insurance payouts and reimbursement from the federal government based on the amount of testing they conducted. The company administered thousands of tests weekly under the county contract in 2020 and 2021.

The internal investigation corroborates and expands on many details LAist found in a recent investigation into the county’s contract with 360 Clinic. Internal emails and text messages LAist obtained under the Public Records Act showed that former Supervisor Andrew Do overrode county staff concerns and directed them to use county money to pay the clinic for claims that had been denied by private insurance companies because of concerns including over billing. Do was sentenced to five years in prison last week on a felony bribery charge stemming from more than a half a million dollars in kickbacks he received from other county contractors who were supposed to provide meals to needy seniors.

LAist obtained a copy of the county investigation’s findings, which are contained in an internal memo dated June 6, through a California Public Records Act request.

The county’s internal investigation of 360 Clinic’s COVID-19 testing contract was carried out by Kelly Sabet, the county’s chief compliance officer. It was prompted by a tip last fall about double billing for testing services submitted through the Orange County Fraud Hotline, according to the report.

Sabet sent the results of the investigation in an internal memo addressed to Veronica Kelley, director of the county Health Care Agency, which managed the testing contract. Sabet concluded that the agency “is required to seek repayment from 360 Clinic for all payments that were fraudulently obtained by 360 Clinic.” She also recommended a forensic audit of the contract. The investigation findings have been turned over to county counsel and to the county’s internal audit department.

Stuart Pfeifer, a spokesperson for 360 Clinic, told LAist that the company had not been contacted about the investigation or its findings until contacted by LAist. In a statement to LAist, he wrote, “This memo contains serious unsubstantiated claims alleged against 360 Clinic, some of which are demonstrably false and others in which 360 Clinic is unable to respond to further because it does not have sufficient information at this time.”

Pfeifer provided emails and documentation to LAist of the cashier’s check from 360 Clinic to the county’s Health Care Agency, which was cited in the county’s investigation as missing. He said that when 360 Clinic was alerted to the missing funds in September 2024, the company issued a new check and delivered it.

Paul Meyer, Do’s criminal attorney told LAist, “It is inappropriate to comment at this time,” in an email replying to our request for a response to the allegations.

After getting a copy of the report last week, Supervisor Janet Nguyen, who represents Do’s former district, sent a letter to U.S. Attorney General Pam Bondi asking her to investigate Do’s involvement in the 360 Clinic contract along with a lucrative property deal, signed by Do when he was chair of the CalOptima board, that would have awarded enormous profit to some of the same principals behind 360 Clinic. LAist reported on that deal last month.

Nguyen told LAist in a phone interview that she had heard concerns from community members about 360 Clinic, including allegations that the company was double billing for COVID-19 tests.

“ I'm angry to know that what we heard out there is coming to fruition,” she said.

“I wish I could say that I was surprised, but I'm not,” she said.

She said even when there were red flags from Health Care Agency leaders and the county’s lawyer, county staff “still proceeded just because the chairman of the Board of Supervisors [Do] told them to do so.”

Supervisor Doug Chaffee, who was on the county’s two-person ad hoc COVID-19 testing committee with Do, told LAist he hadn’t yet read the county’s investigation into 360 Clinic but that the county would do further investigation. Chaffee said he and other county supervisors have to rely on staff to monitor compliance with contracts, especially during emergencies like the pandemic.

“During the time, there were hundreds of contracts that went out,” he said. “Because COVID was so unknown, it wasn’t easy to figure out who was doing the right thing or not.”

Supervisor Katrina Foley told LAist that she was “not in a position to say whether there was wrongdoing or not. I don’t know."

“We need to have a forensic analysis done to ferret out whether there’s any wrongful conduct here. I want to wait for that process to play itself out,” she said.

Veronica Kelley, director of the O.C. Health Care Agency, said that the agency is in the midst of “reevaluating all of our policies and procedures.”

“We want to clean up, see what we want to do better,” she said.

The county's contract with 360 Clinic

Do announced the county’s partnership with 360 Clinic at a Board of Supervisors meeting in July 2020. The plan was to set up large-scale drive-through COVID-19 testing sites at the Anaheim Convention Center and the O.C. Fairgrounds, with thousands of tests per week.

State business records show 360 Clinic was formed less than a week before that announcement. Clayton Chau, then the director of the county Health Care Agency, told supervisors at that July meeting that he knew Gary Nguyen, one of 360 Clinic’s founders, from previous work. Gary Nguyen is not related to Supervisor Janet Nguyen.

The company’s contract was rushed through under a pandemic-era emergency rule. Under that rule, there was no competitive bidding for the work, the full Board of Supervisors never voted on it, and the payment details were never revealed in a public meeting.

The COVID-19 testing contract with 360 Clinic was initially supposed to cost Orange County taxpayers nothing. State and federal rules required private insurance companies to cover COVID-19 testing, and the cost for testing uninsured people was covered under a federal program to reimburse testing providers. But the county and 360 Clinic agreed to amend the contract two months after testing began in July 2020 to put the county on the hook for uncollectible claims. Still, the contract stated that the company agreed to seek reimbursement from insurance or the federal government “to the greatest extent possible.”

Ultimately, the county ended up paying 360 Clinic just over $3.4 million to cover testing the company said it couldn’t collect from private insurance on, according to Ellen Guevara, a spokesperson for the Health Care Agency.

Gary Nguyen, left, co-founder of 360 Clinic, along with 360 Clinic's Dr. Dung Trinh, center and 360 Clinic CEO Dr. Venessa Ho attend the opening of the new COVID-19 testing clinic at Anaheim Convention Center, in July 2020.

(

Carolyn Cole

/

Los Angeles Times via Getty Images

)

360 Clinic got paid for some claims twice, investigators say

During the length of the contract, 360 Clinic would periodically submit lists of claims to the county Health Care Agency for which it said it couldn’t collect private insurance or federal reimbursement, according to internal emails reviewed by LAist. Proof of the claim denials wasn’t required until May 2021, nearly a year into the contract, according to the investigation report.

In its investigation, the compliance office reviewed a sampling of claims and found that 360 Clinic submitted some claims to the county twice and got paid twice for the same claims. The compliance office also found at least one claim for which 360 Clinic billed for and was paid three times — twice by the county Health Care Agency and once by the private insurance company Blue Shield.

Sabet, the chief compliance officer who led the investigation, wrote in her report that 360 Clinic had indicated to the Health Care Agency that the claim had been denied by Blue Shield, citing "Claim not covered by this payer/contractor. Incorrect Insurance." But Sabet confirmed with Blue Shield that they had, in fact, paid the claim, she wrote in the report.

“360 Clinic also included this claim on two separate uncollectable reports resulting in 360 Clinic receiving payment from HCA twice for the same service in addition to the payment from Blue Shield,” the report reads.

Pfeifer, the spokesperson for 360 Clinic, wrote in an email to LAist that the county investigation didn’t include “specific documentation” to support the claims that 360 Clinic engaged in billing fraud, and therefore, the firm couldn’t respond to those allegations.

“360 Clinic provided critical services for OCHCA and the public during one of the most chaotic times in recent history. The memo presumes fraud without any basis, and we would welcome the opportunity to review the actual claims at issue,” he wrote.

Pfeifer told LAist that the company’s leaders intend to meet with Health Care Agency leaders “in the coming days to discuss the findings and provide clarification.”

County paid claims denied by Blue Shield despite concerns about inappropriate billing

LAist has been investigating the county’s contract with 360 Clinic since the beginning of this year. Our investigation, which was based on public records and interviews, found, and the county’s recent internal investigation corroborated, that in 2021 Blue Shield of California was investigating claims submitted by 360 Clinic for testing done through the county’s sites, and ultimately denied many claims. Their reason for denying those claims, according to the internal investigation report, was stated as “charges exceed fee arrangement” or “claim lacks information for medical necessity.”

Sabet, the compliance officer, noted in her report that concerns of “potential upcoding by 360 Clinic to insurance providers,” in other words, billing insurance for services that are more expensive than the ones actually provided, “may have resulted in the denied claims.”

While the Blue Shield of California investigation was ongoing, emails between O.C. Health Care Agency leaders reported in May by LAist and referenced in the county’s internal report show that the question of whether to pay 360 Clinic for claims the insurer had denied got kicked up to the highest level — to Andrew Do, who was a supervisor at the time. The report cites a text message, previously reported by LAist, sent on Oct. 19, 2021, from Clayton Chau, the Health Care Agency director at the time, that reads: “Just talked to Sup Do. We should pay 360 to fulfill our contractual obligation.”

In response to a list of emailed questions about Blue Shield of California’s investigation into 360 Clinic claims, Mark Seelig, a spokesperson for Blue Shield of California, wrote that the insurer “does not comment on investigations or litigation.”

In September 2020, 360 Clinic was advanced county funds for an anticipated 34,500 COVID-19 tests.

(

Allen J. Schaben

/

Los Angeles Times via Getty Images

)

Staff concerns about 360 Clinic were never addressed, investigators report

The county’s investigation includes a review of emails among Health Care Agency staff during the pandemic. It found that high-level staff had concerns about 360 Clinic’s billing and operating practices at the time, even expressing concerns about how to “keep 360 honest” as the company sought to set up new partnerships with cities around Orange County.

The emails indicate that “360 Clinic may have been engaged in conduct that could be considered fraud, waste, or abuse,” the report reads, adding that county staff’s failure to report those concerns conflicts with county rules requiring employees to report potential violations to her office.

The report also notes that O.C. Health Care Agency staff interviewed for the report emphasized that the emergency nature of the pandemic required them to act fast, “prompting adjustments” to the county’s standard business practices.

After 360 Clinic secured the county testing contract in July 2020, it went on to partner on COVID-19 testing with the U.S. Navy in 2021 and with various Orange County cities, including Santa Ana and Irvine.

More details on the missing check

The investigation raises questions about apparent lapses in the county’s oversight of the lucrative contract.

Toward the beginning of her investigation, in September 2024, Sabet, the chief compliance officer, discovered that the Health Care Agency had no record of receiving $523,650 owed by 360 Clinic in 2020, according to her report.

The payment was reimbursement for money the county had advanced to 360 Clinic to pay for COVID-19 testing. Under the contract, the company was supposed to reimburse the county after it collected payment from private insurance companies and the federal government.

Pfeifer, the 360 Clinic spokesperson, shared emails from September 2024 to and from 360 Clinic leaders and county staff about the missing funds. In one of them, Vince Tien, 360 Clinic’s chief executive, writes that David Ngo, the company’s chief financial officer, had hand-delivered a cashier’s check for $523,650 on Dec. 31, 2020, to Brittany Davis, a procurement contract manager for the county.

Included in the email was a digital photo of the check, issued by Chase Bank, dated Dec. 31, 2020, as well as a redacted copy of the company’s bank statement for that month, showing the money was withdrawn. The memo portion of the check includes the contract number and reads “Advance repayment - Attn: Brittany Davis.”

Davis does not remember receiving that check, Guevara, the Health Care Agency spokesperson, told LAist in an email. Guevara added: “There is no record of a check being delivered or received by any method on or around that day. It was never cashed because it was not received.”

After the county communicated with 360 Clinic about the missing funds — more than three years after the contract ended — Chase Bank canceled the old check and issued a new cashier’s check, which the county says it received on Oct. 8, 2024.

Sabet’s report does not mention that 360 Clinic had initially issued the check in 2020. Pfeifer, in an email to LAist, said that omission “calls into question the credibility of all of the allegations.”

LAist discussed details about the missing check with Ruben Allen Davila, an accounting expert at the University of Southern California Marshall School of Business.

He said if the county did lose the check back in 2020, it wouldn’t be that shocking.

“Government agencies are not the most efficient organizations,” he said.

Still, he said, “How the hell would someone not cash a half a million dollar check?”

He noted that it's unlikely 360 Clinic could have benefited from an uncashed cashier’s check, since the money would have been taken out of the company’s account at the time because that’s how cashier’s checks work. But he also found it strange that the company didn’t follow up to make sure the county cashed the check.

“For half a million dollars, I’d want to be aware the payment was satisfied,” like with a receipt, he said..

Davila also said it was unusual that the county didn’t contact 360 Clinic about its investigation. “It doesn’t make sense to do an investigation about a company without talking to them,” he said.

Nick Gerda contributed to this story.