Convicted Fraudster Petitions SCOTUS

The convicted head of a workers’ comp bribery scheme that generated hundreds of millions of dollars in fraudulent MRI services claims is asking the United States Supreme Court to take up the case and reverse his conviction. The petition for certiorari argues that Sam Solakyan was convicted under a fraud theory that several other federal … Read More »

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$3 Million In Restitution In Two Premium Fraud Cases

District Attorneys in Los Angeles and San Diego notched victories against two employers for underreporting payroll to avoid workers’ comp premiums. The San Diego DA won a $1 million restitution order against a plumbing company, while the Los Angeles DA’s office secured a nearly $2.3 million order against a couple operating three delivery services. John … Read More »

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Solakyan Appealing Fraud Conviction To U.S. Supreme Court

The Ninth Circuit Court of Appeal members voted to reject a petition for rehearing and rehearing en banc by the convicted head of a workers’ comp bribery scheme that generated $263 million in fraudulent claims for MRI services. Sam Solakyan filed the petition after the Ninth Circuit affirmed all counts of his conviction last fall. … Read More »

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DIR and TPA Settle Dispute Over Failed Audit

The Division of Workers’ Compensation agreed to drop nearly $200,000 in administrative penalties against Keenan and Associates, a Third-Party Administrator that failed a DIR claims audit. For its part, Keenan agreed to fix the problems identified in the audit and drop its appeal. The settlement leaves the failing grade intact. The deal was revealed as … Read More »

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Fraud Commission Approves Funding Change

The California Department of Insurance Fraud Assessment Commission (FAC) approved another one-year adjustment to the anti-fraud funding formula. This one will redirect approximately $4 million away from county district attorneys and give it to the Department. Insurance Commissioner Ricardo Lara requested the change after DAs again failed to use the entirety of the grants provided … Read More »

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Fraud Referrals Rebound

The number of suspected workers’ comp fraud cases (SFCs) referred to California Department of Insurance investigators is returning to normal. Referrals plummeted during the pandemic. The Department’s Fraud Division received nearly 3,000 referrals last year involving cases with more than $149 million in potential losses. California Insurance Code section 1872.4 requires carriers to report suspected … Read More »

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Charges In Southern California Kickback Scheme

The Orange County District Attorney’s Office announced a 13-count felony complaint against a twice-convicted felon that accuses him of running a kickback scheme that generated $100 million in fraudulent bills on workers’ comp claims. Charged along with three others, the ringleader allegedly created a medical management company that ran clinics and steered workers’ comp claimants … Read More »

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State Bar Pursues Disciplinary Action

The State Bar of California will hold a disciplinary hearing next month to determine if attorney Matthew Rifat’s conviction for soliciting business with reckless disregard for an entity’s intent to commit insurance fraud constitutes moral turpitude. The attorney was connected to an alleged medical mill in Riverside County that prosecutors said bilked the system out … Read More »

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