A complex investigation into one of the largest cases of workers compensation health care insurance fraud in department history has led to 13 indictments announced recently against seven Southern California-based medical professionals.
This is the second wave of indictments against attorneys, doctors and medical providers who ripped off nearly 20 insurance companies by taking kickbacks totaling nearly half a million dollars for treatments, including chiropractic, pain management, echo cardiograms and even sleep studies resulting in millions of dollars of fraudulent workers compensation insurance claims.
These indictments are the result of a joint investigation by the Department of Insurance, FBI, U.S. Attorney’s Office, and the San Diego District Attorney’s Office. The operation was first announced in November when federal indictments were handed down to eight defendants including doctors and their associates.
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“These providers built an elaborate and illegal kickback and bribery scheme that bought and sold patients — putting profits ahead of patient medical needs,” said Insurance Commissioner Dave Jones. “Workers compensation is designed to protect injured workers and legitimate businesses, not create a fraudulent profit center for providers bent on taking advantage of the system. Fraudulent enterprises like this create a multi-billion dollar drain on California’s economy.”
In addition to the state charges, the U.S. Attorney’s Office announced federal indictments against three additional defendants who allegedly recruited individuals to file workers comp claims’ resulting from on-the-job injuries.
The defendants then directed these patients to specific chiropractors who met a pre-determined quota of referring new patients for goods and services such as MRIs and medical equipment.
Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com. Contact: kstack@reduceyourworkerscomp.com.
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