Tagged in: fraud

Third Amended SIU Reg Package Out For Comment

The California Department of Insurance’s continuing effort to update the rules for insurance carriers’ special investigative units (SIU) has produced a third set of amended draft regulations with changes to streamline some provisions while expanding on others. The updates also reflect the reality of the lengthy rulemaking process, which started over a year ago with … Read More »

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$20 Million Fraud Scheme Busted

Orange County prosecutors filed felony charges against two people in an alleged kickback and workers’ comp insurance fraud scheme. Prosecutors say that Bradley Dan Groscost and Felix Koltsov concocted a plan that ultimately billed workers’ comp carriers over $20 million for urine drug screenings and prescriptions for compounded creams. The scheme was driven by $2 … Read More »

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Santa Clara Busts Another Voc Rehab Provider In Alleged Kickback Scheme

The Santa Clara District Attorney filed workers’ comp fraud charges against the owner of a vocational training school for allegedly taking $650,000 in Supplemental Job Displacement Benefit (SJDB) payments, but never providing the training. The case is linked to another criminal case against a vocational training school filed earlier this year as both schools had … Read More »

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MRI Provider Charged with Bribery

United States Attorneys are due in court early next month to prosecute a 12-count workers’ comp fraud indictment. It is against Sam Solakyan for his alleged role in a major kickback scheme. Solakyan ran an MRI network under the names Vital Imaging and San Diego MRI Institute. Solakyan is seeking a dismissal. He is claiming … Read More »

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DAs Get Fraud Funding Increase, But Less Than Sought

California’s district attorneys said they needed a 20% increase in funding to fight workers’ comp fraud to the fullest extent, but said they could make do with a 14% increase. An 8% increase, however, will have to suffice as members of the California Fraud Assessment Commission approved a nearly $5.8 million increase in the assessment … Read More »

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Department Unveils Updated SIU Regulations

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 … Read More »

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Lien Stay Provisions Beat Another Constitutional Challenge

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 … Read More »

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