The California Department of Insurance is moving forward with a formal proposal to update regulations governing insurers special investigative units (SIU). The Department floated a draft proposal earlier this year but received strong pushback from the industry. Now carriers and others will have the opportunity to comment on an updated proposal as part of the …
California’s rules for staying liens when providers are charged with workers’ comp fraud survived yet another constitutional challenge. This one didn’t even require a court hearing. The Fourth District Court of Appeal rejected the lienholder’s petition for writ of mandate with a simple one-line order and deemed no further discussion was necessary. The rules came …
Workers’ comp fraud investigators and local prosecutors continue to crack down on scams that are bilking the Supplemental Job Displacement Benefit (SJDB) system for thousands of dollars at a time. The latest case involved two principles behind a Southern California technical school that made fraudulent claims with at least a half-dozen different carriers. These cases, …
Prosecutors filed charges against the owners and operators of the Center for Better Health, AKA the Southland Spine and Rehabilitation Medical Center, in Costa Mesa and Riverside for allegedly submitting nearly $3 million in fraudulent workers’ comp bills. The scheme allegedly has links to capping operations run through Grupo Medlegal LA/Medlegal Network Inc, as well …
California’s prosecutors are making headway in efforts to get bad actors out of the state’s workers’ comp system. They recently secured guilty pleas from two providers in a case that generated millions in fraudulent bills. Much of the alleged fraud, however, was not prosecuted but any resulting liens are subject to a stay and possible …
Chiropractor Paul Turley copped a plea to his role in a $150 million workers’ comp fraud and conspiracy scheme that bilked California employers for years. The scheme allegedly paid applicant attorneys and cappers up to $10,000 a month for patient referrals. Turley is one of a dozen defendants (for past coverage of the case see …
The Los Angeles District Attorney’s Office filed a 12-count indictment against the brother and sister owners of a Southern California construction company. Allegedly State Compensation Insurance Fund was cheated out of $6 million in premium. Charged are Enrique Vera, the owner of Ultimate Inc., and his sister Gloria Vera the company’s office manager. The pair …
The United States Attorney for the Southern District of California unsealed a 12-count indictment and arrest warrant against the head of a statewide imaging network with alleged ties to another well-publicized kickback and referral scheme. The indictment against Sam Solakyan who ran Vital Imaging, San Diego MRI Institute, Global Holdings, and other operations includes charges …