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Dave Jones Takes Action In The Face Of Illegal Auto Policy Moratoriums In Southland Wildfire Areas
December 7, 2017
California's Department of Workers' Compensation (DWC) Announces Final Approval to Adopt a Drug Formulary for the Medical Treatment of Injured Workers
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California Department of Workers' Compensation Posts Adjustments to Official Medical Fee Schedule (Physician Services/Non-Physician Practitioner Services)
|California Department of Workers’ Compensation Suspends 21 Medical Providers: 18 For Fraud And Three For Physical and/or Mental Conditions Requiring Surrender Of Medical Licenses|
By Lonce Lamonte - December 4, 2017
The California Department of Industrial Relations’ Division of Workers’ Compensation (DWC) has suspended 21 more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended this year to 115. The providers were suspended for fraud, other criminal actions, or else for physical and mental conditions prohibiting their safe and effective use as medical practitioners, thus provoking surrender of their medical licenses.
DWC Administrative Director George Parisotto issued suspension orders against the following providers.
The following providers participated in an illegal kickback scheme to issue unnecessary prescriptions for durable medical equipment (DME) to Medicare patients:
George Samuel Laing of Long Beach, manager and operator of Pacific Clinic, was convicted in federal court in 2013 of multiple counts of health care fraud for his involvement in a fraudulent Medicare billing scheme with physicians Augustus Ohemeng and George Tarryk, and DME supplier Emmanuel Chidueme. Laing recruited Ohemeng and Tarryk as treating physicians and used recruiters to bring Medicare beneficiaries to the Pacific Clinic. After Ohemeng and Tarryk wrote the fraudulent prescriptions, Laing referred the prescriptions to DME supply companies in exchange for illegal kickback payments. Laing and his co-conspirators fraudulently billed Medicare over five million dollars.
Augustus Ohemeng, Buena Park physician, was convicted in federal court in 2013 of multiple counts of health care fraud for his involvement in a Medicare billing scheme. Ohemeng and his co-conspirators fraudulently billed Medicare more than five million dollars. He was sentenced to 42 months in prison and ordered to pay nearly three million dollars in restitution. The medical board revoked his license in 2016.
George Tarryk, Long Beach physician, was convicted in federal court in 2013 of one count of health care fraud for his involvement in a fraudulent Medicare billing scheme. Tarryk and his co-conspirators fraudulently billed Medicare more than five million dollars. Tarryk was ordered to pay over $800,000 in restitution.
Emmanuel Chidueme of Anaheim, owner and operator of DME company Ivy Medical Supply, was convicted in federal court of health care fraud, sentenced to 37 months in federal prison and was ordered to pay restitution. He received prescriptions from co-conspirators Ohemeng and Tarryk for medically unnecessary durable equipment and fraudulently billed Medicare.
The following providers participated in an illegal kickback scheme to bill Medicare for home health care services that were not provided:
Sang Ahn, Los Angeles recruiter, was convicted in federal court of conspiracy to commit health care fraud. She was sentenced to four months in prison followed by three years of supervised release and was ordered to pay restitution along with co-conspirator Yeong Ja Lee and others. Ahn recruited Medicare recipients for home health care provider Greatcare Home Health, paid physicians kickbacks to order home health care services from Greatcare and received kickbacks from Greatcare for each referral. The services were billed to Medicare, but were not medically necessary, were not provided or were provided by unlicensed personnel.
Yeong Ja Lee of Los Angeles, employee of home health care provider Greatcare Home Health, was convicted in federal court in 2014 of conspiracy to commit health care fraud. She was sentenced to 15 months in prison followed by three years of supervised release and was ordered to pay restitution. Lee participated in a scheme to fraudulently bill Medicare for home health care services that were not provided or for billing physical therapy services when they were not provided.
· Edward Bui Hai, Highland physician, had his medical license revoked this year after the Medical Board of California’s decision that the provider is unable to practice medicine safely due to disabling hearing loss, visual impairment and probable dementia. Additional grounds for revocation were his unprofessional conduct related to findings of negligence and gross negligence in his treatment of multiple patients when he prescribed controlled substances without medical indication or assessing the effects of those prescriptions.
· Cesar Antonio Banda, Fair Oaks physician, had his medical license revoked this year for prescribing controlled substances to multiple patients without examination or medical indication. His conduct was found to constitute gross negligence, repeated acts of negligence, corrupt and dishonest acts, false representations and inadequate recordkeeping.
· Margaret Mary Haggerty, Tracy physician, had her medical license revoked this year due to a mental and physical illness that impairs her ability to safely practice medicine.
· Kiansi Blaise Boni, Torrance physician, had his medical license revoked this year for gross negligence and repeated acts of negligence in his treatment of a patient. Boni prescribed controlled substances without performing an appropriate physical examination and practiced medicine while his license was suspended.
· Ariel Eliahou Abrahams, Los Angeles physician, had his medical license revoked this year for failure to comply with the terms of probation imposed by the Medical Board of California following prior disciplinary proceedings. The board’s prior proceedings found gross negligence relating to patient care.
· Frederick Michael Silvers, Los Angeles physician, had his medical license revoked this year for prescribing controlled substances to patients with histories of substance abuse without clinical support.
· Sacha Comden, Santa Monica physician, had her license revoked this year for violating the terms of her probation imposed by the Medical Board of California.
· Thomas Michael Ehlinger, Ojai physician, had his medical license revoked this year following the stipulated surrender of his medical license from the state of Washington.
· Alfred D. Trotter, Jr., Chula Vista physician, had his medical license revoked this year for gross negligence, failure to diagnose and for performing surgery without appropriate medical indication.
· Daniel Cham, Alhambra physician, was convicted in 2016 in federal court of charges related to the distribution of oxycodone and money laundering. His medical license was revoked in 2016 for conduct leading to his conviction.
· John Anthony Flores, Mission Hills physician, had his medical license revoked in 2016 following the suspension of his New Mexico medical license on the grounds that his continued practice of medicine posed a clear and immediate danger to public health and safety.
· Emilio Joseph Miranda, Los Angeles physician, had his medical license revoked in 2016 for failing to comply with an order from the Medical Board of California compelling him to submit to a mental and physical examination.
· Hrayr Karnig Shahinian, Los Angeles physician, had his medical license revoked in 2016 for advertising untrue and misleading information to patients by overstating his training and qualifications.
· Hossain Sahlolbei, Blythe physician, was convicted of grand theft in Riverside in 2016. His medical license revocation proceeding is pending before the Medical Board of California.
· Charles Roy Phillips, Fresno physician, had his medical license revoked in 2014 due to a mental illness that affects competency.
AB 1244, which went into effect January 1, requires DWC’s Administrative Director to suspend any medical provider, physician or practitioner from participating in the workers’ compensation system in cases in which one or more of the following is true:
The provider has been convicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ compensation system, fraud or abuse of a patient, or related types of misconduct;
The provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or
The provider’s license or certificate to provide health care has been surrendered or revoked.
The Department of Industrial Relation’s (DIR’s) fraud prevention efforts are posted online, including frequently updated lists for physicians, practitioners, and providers who have been issued notices of suspension, and those who have been suspended pursuant to Labor Code §139.21(a)(1). The department recently added a new web page with information on lien consolidations and the Special Adjudication Unit.
Lonce Lamonte, journalist, firstname.lastname@example.org; with input from Newsline from California's Department of Industrial Relations' Division of Workers' Compensation from the state of California: dir.ca.gov