The widow of a former San Diego deputy district attorney previously accused of using workers’ comp fraud prosecutions to further sexual relations with defendants, including her, is now suing claiming that she too was a victim of malicious prosecution. Before their marriage, the widow and her former husband, a construction industry contractor, were allegedly prosecuted for …
Two executives and the accountant for a high-end garment manufacturer will be sentenced next month for their role in cheating a handful of workers’ compensation carriers out of nearly $3.2 million in workers’ comp premiums. The trio also cheated the state out of employment taxes when they underreported their payroll. Sung Hyun Kim and Jae …
Regulations designed to implement the anti-fraud reforms enacted this year as part of the SB 1160 legislation are just about out. The Workers’ Compensation Appeals Board is also opening the public comment period on a set of regulations to introduce new rules for workers’ comp liens. The Division of Workers’ Compensation is also nearly ready …
Gov. Jerry Brown signed two workers’ comp anti-fraud bills. One targets provider fraud and the other aims to knock out fraudulent medical liens. As a result of the bill signings, the bureau also amended its Jan. 1, 2017 rate filing to boost its recommended rate cut from 2.6% to 4.3% next year. The added rate …
The California Department of Insurance arrested three individuals including a registered qualified medical evaluator (QME) in a scheme to defraud health insurers by artificially inflating bills. The three face charges of conspiracy to submit at least $380,000 in fraudulent bills for laboratory services. Arrested were Dr. Edward Albert G. Balbas, chiropractor Jon Brunelle, and Alejandra …
Skyrocketing workers’ comp pharmaceutical costs are coming back to earth. Driving the change is a sharp drop in in-office dispensing by treating providers and a reduction in the use of compounded medications. Researchers say this decline correlates to significant workers’ comp fraud busts of providers and pharmacies, as well as much stricter regulation of compounding. …
California employers will be paying a little bit more next year to fight workers’ comp fraud in all its various forms. The California Fraud Assessment Commission voted to increase the aggregate assessment for funding the anti-fraud efforts by 5.7% next year – the first increase the Commission has granted in two years. The increase in …
District attorney’s from 37 California counties next year will be sharing nearly $35 million to combat workers’ comp fraud in their jurisdictions. The anti-fraud grants range from a low of $47,000 up to $6.7 million. California employers supply the fraud fighting funds through assessments on the workers’ comp premiums they pay or through direct assessments …