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News
Release No.: 2017-12
Date:
February 16, 2017
CALIFORNIA DIR
and Division of Workers’ Compensation Suspend Seven Providers for Fraud
Liens associated with the suspended
providers total $59 million
Oakland—The Department of
Industrial Relations and its Division of Workers’ Compensation today
announced it has suspended seven medical providers from participating in
California’s workers’ compensation system. The providers have been convicted
of workers’ comp fraud or have been suspended from the Medicare or Medicaid
programs for medical fraud. The suspended providers have filed more than
8,500 liens in California’s workers’ compensation system, with a total of
claim value of at least $59 million.
“We are moving quickly to use new anti-fraud tools at our
disposal to suspend those proven to game the workers’ comp system at the
expense of injured workers and employers,” said Division of Workers’
Compensation acting administrative director George Parisotto.
“Workers’ compensation fraud undermines the state’s efforts to
increase payments and improve services to injured workers, and to reduce
costs for employers,” said DIR Director Christine Baker. “Removing fraudulent
providers and staying lien claims of those criminally-charged with fraud will
further reduce costs in the system.”
The suspended providers include:
·
Philip Sobol, an
orthopedic surgeon in Los Angeles convicted in Santa Ana’s federal District
Court for insurance mail fraud and other charges connected to receiving
workers’ comp kickbacks. Dr. Sobol has nearly 6,000 active workers’
compensation liens with an estimated total claim value of more than $42.7
million.
·
Jason Hui-Tek Yang, a
psychiatrist in Pasadena convicted in Riverside County Superior Court for his
involvement in an insurance fraud conspiracy, including the referral of
patients for unnecessary care to justify workers’ compensation billing. Dr.
Yang has over 2,000 active workers’ compensation liens with an estimated
total claim value of more than $13.7 million.
·
Alan Ivar, a chiropractor
in Costa Mesa convicted in Santa Ana’s federal District Court for referring
patients to a Long Beach hospital in a kickback scheme for well over a
decade. Dr. Ivar still has over 400 active workers’ compensation liens with
an estimated total claim value of more than $2.5 million.
·
Thomas M. Heric, a
physician in Los Angeles convicted in Sacramento’s federal District Court for
health care fraud related to the Medicare and Medicaid programs who was
suspended from those programs.
· Carlos Arguello, a Chula
Vista businessman convicted in San Diego’s federal District Court for his
role in a kickback scheme that involved referring injured workers to specific
chiropractors for medical care regardless of their injuries.
·
Daniel Dahan, a former
chiropractor in Long Beach suspended from the Medicare and Medicaid programs
who surrendered his license to practice.
·
Boniface Okwudili Onubah,
a former neurologist in Marina Del Rey suspended from the Medicare and
Medicaid programs whose medical license was revoked.
Suspension notices were issued to the providers on January 17,
2017, by the Division of Workers’ Compensation’s Acting Administrative
Director George Parisotto. The suspension becomes effective 30 days
later if the provider does not appeal the action.
An additional three providers who were notified of the pending
suspension have filed appeals of the action. Those appeals are in process.
AB 1244 (Gray and Daly) requires the Division of Workers’
Compensation (DWC) Administrative Director to suspend any medical provider,
physician or practitioner from participating in the workers’ compensation
system when convicted of fraud. DWC has adopted provider
suspension regulations on the new law, which requires providers to be
suspended from the system for one or more of the following grounds:
DIR has posted information on its fraud prevention efforts
online, including a report on its anti-fraud efforts in the California
workers’ compensation system.
DIR protects and improves the health, safety and economic
well-being of over 18 million wage earners, and helps their employers comply with
state labor laws. DIR’s Division
of Workers’ Compensation monitors the administration of workers'
compensation claims, and provides administrative and judicial services to
assist in resolving disputes that arise in connection with claims for
workers' compensation benefits.
Members
of the press may contact Erika Monterroza or Peter Melton at (510) 286-1161,
and are encouraged to subscribe
to get email alerts on DIR’s press releases or other
departmental updates.
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The California Department of Industrial Relations,
established in 1927, protects and improves the health, safety, and economic
well-being of over 18 million wage earners, and helps their employers comply
with state labor laws. DIR is housed within the Labor & Workforce Development
Agency. For general inquiries, contact DIR’s Communications
Call Center at 844-LABOR-DIR (844-522-6734) for help in locating the
appropriate division
or program in our department.
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