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Sim Hoffman, the Buena Park, California, based radiologist who was indicted by an Orange County Grand Jury last May of 2011 for 17 million dollars in fraudulent billings to insurance carriers and third-party administrators handling workers’ compensation cases, appeared for more pre-trial proceedings last Friday, March 16th 2012 in Orange County Superior Court in Santa Ana in court room C-40 before Judge William Froeberg.

Hoffman is out of custody on a 1.5 million dollar bail bond and he appeared in court with his co-defendants, Beverly Mitchell, his office manager, Louis Santillan, his hearing rep and bill collector, and Dr. Thomas Heric, who is a neurologist. The indictment against all four defendants contains 887 counts. All defendants have pled not-guilty.

Robert Moest, Dr. Thomas Heric's defense attorney, scratches his head as he leaves the Orange County court house parking lot by car in the late morning on Friday, March 16th.

The whole scam Hoffman and his cohorts are accused of indulging in is, according to Orange County District Attorney, Tony Rackauckas, “A massive workers’ compensation insurance fraud scheme involving over 17 million dollars in overbilling for unnecessary or never-performed procedures.”

Hoffman devised fake tests and evaluation procedures for Sleep Disorders at his Better Sleeping Medical Center in Buena Park, and also billed for other fake neurological tests from two other companies called Advanced Management Services and Advanced Professional Imaging. There was nothing in his testing that was legitimate or had any medical value. It was all devised and concocted as bogus paperwork for billing purposes.

Now, a Single Fiber EMG is an invasive, painful procedure, which takes over an hour to perform and involves sticking a giant needle into a single nerve. It often requires hospitalization. The needle tests for electricity conduction. Only two doctors in California are qualified to perform this test because it is so complex and requires specialized training, and Hoffman is not one of them.

Sim Hoffman, M.D., center and on the right, strolls with his attorney, Richard Moss, to the parking lot of the Orange County Superior Court after proceedings on March 16th 2012.

According to his bills, his patients went through this painful procedure over 20 times each. There’s no way that could ever happen. And by the way, Single Fiber EMGs are ten times more expensive than regular EMGs.

So, Friday’s proceedings started off with Beverly Mitchell’s attorney telling Judge Froeberg, “We’re pulling this over until the 18th of May, until we do the discovery issues”.

The Defense is also filing a 995 Motion and that is set for May the 18th. In California, Penal Code 995 is a Motion to Dismiss the Information based upon lack of probable cause or sufficient evidence. The Defense already filed a Demurrer at a previous proceeding, which is a pleading that objects to the legality of a count or counts, but that was denied.

Then Richard Moss, who is Sim Hoffman’s attorney and who is quite slender and was wearing a handsome, dark sapphire blue, tailored suit, asked the Judge about his Motion For Discovery that he filed. But the Judge didn’t have it. So, that burned up some time while the Judge located the Motion and then left the court room silently and went into his back chambers to read it.

Well, while the judge was gone, every one in the court room just chatted with each other, and I even got the chance to turn around and have a casual chat with Louis Santillan, who was sitting in the row just behind me. He’s a man who appears very sweet on first impression and wears very chic designer eye glasses. One would never suspect he would be caught up in a criminal debacle like this based on his benign appearance, but according to the DA he collected over 800,000 dollars in commissions over two years derived from activities that he knew were fraudulent.

Well, when the judge came back he denied the Motion. And there was some light banter back and forth between Judge Froeberg and Richard Moss about it. Then, Moss told the judge that the state of California allocates large sums of money to the Orange County District Attorney’s office to go after workers’ compensation medical providers and this somehow creates a conflict of interest.

Sim Hoffman, M.D., drives away from the Orange County Superior Court House after his appearance on Friday, March 16th.

After the proceedings were over, I got lucky and found myself in the elevator alone with the Deputy District Attorney who is trying this case, Shaddi Kamiabipour. I immediately piped up when the elevator door closed and so she told me that the Defense is doing everything under the sun to attack the DA’s case.

Since the State of California, she explained, especially the Department of Insurance, grants money to the DA’s office to prosecute workers’ compensation fraud, the Defense is alleging the money was specifically allocated solely to attack Sim Hoffman.

But, this is absolutely not true, according to Shaddi. The money from the state has been utilized to prosecute many MANY workers’ compensation fraud doctors, not specifically Sim Hoffman. He is not special.

“Pretty much at this point they are trying to attack the DA’s case any way they can,” Shaddi said. “995s are very common. They are usual. Nobody gets surprised,” she added.

So, a 995 is a disqualification motion, she went on to explain, a challenge, a possible conflict of interest, a lack of impartiality.

“They don’t want this to get to trial,” Shaddi told me without equivocation by the time we reached the sidewalk in front of the Court House.

I remember another thing Deputy DA Shaddi Kamiabipour told me over the phone back in January. She said her office only went back for one year with the billings from Sim Hoffman’s medical practice. She said they had to consolidate or they’d be overwhelmed. The case wouldn’t be manageable otherwise.

So, if the DA indicted for 17 million dollars in fraud for only one year, just think of what 10 years would add up to? We can easily do the math. Oh, my…