How Scott and Alla LaRoque got rich from disputed medical bills

The first encounter between Alla Kosova and Scott LaRoque occurred at a lively party in Las Vegas. Newly divorced, Alla, with a sense of humor, instructed her friend to choose her next husband, leading to an introduction to a stranger in the crowd. 

The following day, prior to their first date, Scott, a Texas-based entrepreneur visiting the city, made a quick stop at the Bellagio to upgrade his $20 shirt for a Giorgio Armani one. Alla arrived to pick him up in a Ferrari. 

Currently, 13 years later, the couple enjoys a life of luxury, complete with a sprawling mansion, a private jet, and a five-day Italian wedding. Their opulent lifestyle is financed by their strategy of extracting substantial sums from the health care system. 

Presenting themselves as heroes akin to Robin Hood, aiding doctors against large insurance firms, their narrative reflects a health care system in the U.S. crowded with profit-seekers who, according to critics, often test legal boundaries. Attempts by lawmakers to curb these excesses are consistently met with adaptive strategies.

The LaRoques own HaloMD, a relatively obscure intermediary that assists providers in navigating a new federal arbitration process for resolving billing disputes with insurers. However, HaloMD is embroiled in lawsuits from four Blue Cross Blue Shield insurers, alleging system manipulation for significant financial gains for the company and its clients. 

Despite the LaRoques’ strong denial of these accusations, one fact remains clear: HaloMD is a dominant player in this arbitration process, established by a 2020 federal law to eliminate surprise billing by out-of-network providers. In the first half of 2025, HaloMD filed more arbitration cases than any other firm, claiming to generate over $1 billion annually for itself and its clients. While not alone in exploiting this law, HaloMD outpaces more established companies in this space, collectively undermining the law’s intent to shield consumers from rising health care costs. 

Documents from court cases, internal company records, and interviews with over 50 individuals shed light on how the LaRoques amassed their fortune through a series of deals with health care providers. Over time, they adapted these strategies to avoid legal challenges and exploit newly discovered loopholes. This investigation by STAT reveals a persistent practice of arranging creative profit-sharing from medical services with physicians at one of their companies, with sources describing such arrangements as unethical and potentially unlawful.