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| | Three Work Comp Fraud Cases Working Through The Courts In Orange County As Dave Jones Grants OC $3,966,000
By Lonce LaMon - August 20, 2015
On August 5th 2015, the California Insurance Commissioner, Dave Jones, announced that he had awarded 34.9 million dollars in grants to district attorneys throughout California for the next fiscal year, 2015 to 2016, specifically to prosecute workers’ compensation fraud. This money comes from the Employer Assessment Fund.
On May 15th 2015, Don Marshall, who is a chair on the Fraud Assessment Commission for workers’ compensation for the state of California, said in his speech at the Big Fraud Conference at the Pala Casino in Riverside County, that the assessments went up by 10 percent this year, and that the amount had been 51 million dollars. So it’s up to at least 56 million now demonstrating that not all of the money goes just to district attorneys. More than 20 million goes to other agencies including those specialized in fighting workers’ compensation fraud within the California Department of Insurance.
Don Marshall said within that May 15th speech, “The Department of Insurance have started taking on the big players. You’ve heard about that today about some of these cases that have been going on for years. Because of the amount of time that is spent to hold these things on. It’s a defense tactic.”
Orange County was granted $3,966,000. And here’s what’s going on in the O.C.:
On the Kareem Ahmed case, also referred to as the Landmark Medical case, the Court of Appeal, Fourth Appellate District, Division Three, has not yet responded to the Writ of Mandate filed by the Defense in this 200-million-dollar workers’ compensation fraud debacle involving illegal manufacturing, distributing, and prescribing of compound medications. The Writ was sent back to the Court of Appeal on or about April 29th 2015 by the California Supreme Court after review. The Supreme Court ordered a new Writ be reviewed by the same Court of Appeal that had summararily denied the Writ back in late February 2015.
Kareem Ahmed, CEO of Landmark Medical (left), and Evette Charbonnet, Landmark Medical marketing manager (right), are the two lead defendants in two separate indictments filed by the Orange County District Attorney which include 15 defendants. Photo copyright Lonce LaMon, all rights reserved.
The Orange County District attorney’s office expressed yesterday that an answer from the Court of Appeal, Fourth Appellate District, Division Three is now not expected until mid-to-late September 2015. This fits in with what Don Marshall stated in his May 15th 2015 Pala Resort speech: “We’ve seen a number of these cases be taken repeatedly to the California Supreme Court. So the amount of time, effort, and paperwork needed to manage the cases as they move up through the court system require a lot more resources.”
The Aspen Medical Resources case is going to be heard tomorrow afternoon, Friday August 21st, in Orange County Superior Court at 1:30 pm. This case is still in the pre-trial phase with a scheduled Motion to Dismiss from the Defense. The trial for this case had been set at one time for April 2015.
Aspen Medical Resources was a durable medical equipment company based in Anaheim that capitalized on one machine that was a hot-cold therapy machine. The company egregiously overbilled workers’ compensation payers with this one machine as two machines: one that provided heat and another that provided cold therapy. This prosecution’s case is pleading 36 million dollars in overbilling.
All of the assets of Aspen Medical and the other company names used were seized by the Orange County District Attorney. There have been issues of receivership and search warrants argued in court. The indictment was filed against Aspen and its three owners and one bill collector in January 2014. The owner-defendants are Jeffrey Campau, Landon Mirallegro, and Abraham Khorshad. The bill collector-defendant is Ryan McCracken who is being prosecuted under lesser charges than the owners.
The Preliminary Hearing is still set for September 1st 2015 for Sim Hoffman, M.D. and Thomas Heric, M.D. for their egregious overbilling for bogus services plus service- never-rendered concerning Sleep Studies and Single Fiber EMGs. Dr. Hoffman and Dr. Heric were first indicted in May of 2011 on a previous case to this present one. The first case was dismissed in December of 2013 by now retired Orange County Superior Court Judge William Froeberg on a successful 995 motion filed and argued by Hoffman’s lawyer Richard Moss.
Sim Hoffman, M.D. (left) leaves Orange County Superior Court with his attorney, Richard Moss, on August 19th 2011. The Orange County DA has been prosecuting Hoffman for over 4 years now. The first indictment that wound up getting dismissed was filed in May of 2011. photo by Lonce LaMon, all rights reserved
Motions have been filed by Hoffman’s defense team recently for Judicial Notice of the Landmark Medical case arguing “arguments raised by defendants regarding fair notice therein are identical to the arguments raised by Defendant Hoffman in his Motion to Compel Disclosure of the Claims at issue.” However, the Preliminary Hearing for September 1st, as of today, still remains on calendar.
lonce@adjustercom.com; Lonce LaMon, journalist, all rights reserved
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