When they met, it was at a party in Las Vegas, music bumping. Alla Kosova, newly divorced, told her friend to pick out her next husband, and she ushered over a stranger from the crowd.
The next day, just before their first date, Scott LaRoque, an entrepreneur visiting from Texas, rushed to the Bellagio to swap out his $20 shirt for a Giorgio Armani one. Alla picked him up in a Ferrari.
Today, 13 years, a sprawling mansion, a private jet, and a five-day Italian wedding later, Alla and Scott LaRoque are living lavishly. It’s all funded by their long-running strategy of squeezing as much money as possible from the health care system.
While they portray themselves as Robin Hood-esque heroes helping doctors take on big insurance, their story is emblematic of an American health care system that’s rife with profit-seekers who critics say repeatedly test the lines of legality. Each effort by lawmakers to rein in the excesses is met with retooled tactics.
The LaRoques own a little-known middleman called HaloMD, which helps providers navigate a new federal arbitration process to resolve billing disputes with insurance companies. HaloMD is fighting lawsuits from four different Blue Cross Blue Shield insurers accusing it of rigging the system and triggering huge payouts for itself and its provider clients.
The LaRoques vigorously deny the allegations in the lawsuits, but one fact is not in dispute: HaloMD is dominating this process, which was set up under a 2020 federal law that bans surprise billing by out-of-network providers. It filed more arbitration cases than any other company in the first half of 2025 and boasts that it pulls in over $1 billion a year for itself and its clients. It’s hardly the only company using the law to its advantage, but HaloMD is blowing past larger, more established groups doing similar work. Together, they’re eroding the law’s goal of protecting people from higher health care costs.
Court filings, internal company documents, and interviews with more than 50 people reveal how the LaRoques built their wealth on a series of arrangements with health care providers, and how they evolved over time to both dodge legal scrutiny and, more recently, exploit new loopholes. The STAT investigation exposes a longstanding practice of using creative arrangements to share the proceeds of medical services with physicians at one of their companies, arrangements sources described as unethical and potentially illegal.
