The Orange County, Calif., District Attorney charged four family members and two medical doctors with medical insurance fraud in a $22 million urine test billing scheme operated through a temporary staffing agency and sober living homes.

The family — Pamela, Philip and William Ganong; and Susan Stinson — is accused of starting Compass Rose Staffing in January 2013 as a front to overbill insurance companies for the collection and testing of urine.

The District Attorney alleges the family members owned sober living homes in Orange County, Bakersfield, Los Angeles, and San Diego, through their business William Mae Company, which operated as Compass Rose Recovery. The family fraudulently listed residents and non-residents of Compass as employees of Compass Rose Staffing, and required daily or frequent urine drug testing as a term and condition of employment, according to the DA. The defendants also formed a medical testing lab called Ghostline Labs.

Between 2012 and 2014, the Ganongs are accused of registering fraudulent employees on all four of their payrolls — William Mae Company, Compass Rose Recovery, Compass Rose Staffing and Ghostline Labs — and submitting daily or frequent urine drug test samples for each employee under each company’s health insurance plan.

The Ganongs are accused of paying minimal compensation to those enrolled as employees, not collecting co-pays or deductibles for the urine tests, and providing free rent as a kickback for submitting the urine samples.

To further the scheme, the Ganongs allegedly hired two medical doctors — defendants Carlos Montano, M.D., of Newport Beach, Calif.; and Suzie Schuder, M.D., of Corona Del Mar, Calif. — who are accused of writing urine drug prescriptions starting at three times per week and increasing to seven times per week for most of the Ganongs’ employees.

The defendants are accused of changing insurance carriers four times to avoid detection, billing approximately $22 million to the four insurance companies, and subsequently collecting $15 million.

Maximum sentences for the defendants range from three years in state prison for Susan Stinson to 47 years and eight months in state prison for Pamela Ganong.