Happy New Year 2018. 2017 Closes Out With 28 Final Medical Providers Suspended By California’s Division of Workers’ Compensation For Fraud or Loss of License
By Lonce Lamonte And The California Department Of Industrial Relations' Newsline - January 2, 2018
The California Division of Workers’ Compensation (DWC) last month, December 2017, suspended 28 more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended in 2017 to 159. The providers were suspended for fraud or other criminal actions, or the loss of their license.
DWC Administrative Director George Parisotto issued suspension orders against the following providers:
· Gary Ordog, Newhall physician and operator of a mobile medical clinic, was convicted in 2016 of health care fraud for submitting claims to Medicare totaling approximately $6.5 million. Ordog submitted false and fraudulent claims to Medicare for office visits or other outpatient visits that never occurred.
· Owusu Ananeh Firempong, Beverly Hills physician, was convicted in 2012 in federal court of health care fraud for submitting false and fraudulent claims to Medicare. Firempong was also convicted in 2011 in federal court of conspiracy to distribute cocaine and conspiracy to launder money. Firempong was sentenced to 57 months in federal prison and ordered to pay nearly $800,000 in restitution. Firempong’s medical license was revoked in 2016.
· Khristine Eroshevich, Beverly Hills physician, was convicted in federal court in 2010 of unlawfully prescribing controlled substances by fraud, deceit, misrepresentation, or concealment of a material fact. Eroshevich wrote numerous unnecessary prescriptions for controlled substances using false names and information for individuals who were not her patients. Eroshevich was also suspended by the California Department of Health Care Services from participating in the Medi-Cal program for an indefinite period of time.
· The following providers participated in a scheme that produced unnecessary prescriptions for expensive anti-psychotic medication, fraudulently billing Medicare and Medi-Cal approximately $18 million.
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Arman and Nurista Grigoryan, Glendale operators of Manor Medical Imaging Inc., were convicted in federal court in 2014 of conspiracy to commit health care fraud and conspiracy to possess and use identification documents unlawfully for their participation in a scheme to produce prescriptions for expensive anti-psychotic medications that patients of their clinic did not need. Arman was sentenced to 60 months in federal prison and ordered to pay over $6 million in restitution.
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Lianna and Artak Ovsepian, Taft operators of Manor Medical Imaging, Inc., were convicted in federal court in 2014 of conspiracy to commit health care fraud, conspiracy to possess and use identification documents unlawfully, aggravated identity theft, conspiracy to misbrand prescription drugs and making false statement to a government agency for their participation in the scheme. Lianna was sentenced to 96 months in federal prision, Artak was sentenced to 180 months in federal prison and both were ordered to pay over $9 million in restitution with their co-conspirators.
§ The prescriptions were made to appear signed by Kenneth Wayne Johnson, a provider suspended in May. Johnson did not examine Manor Medical Imaging patients or authorize the prescriptions but he did allow Manor staff to pose as physicians and physician assistants to issue prescriptions in his name.
· The following providers participated in a scheme that fraudulently billed Medicare and Medi-Cal for unnecessary prescriptions for OxyContin.
o Mike Mikaelian and Anjelika Sanamian, Los Angeles operators of Lake Medical Group, were convicted in federal court in 2014 of conspiracy to commit health care fraud, conspiracy to distribute controlled substances and money laundering. Operators Mikaelian and Sanamian produced prescriptions of OxyContin that the clinic’s patients did not need, billing Medicare and Medi-Cal over $6 million. Mikaelian pled guilty in March 2014 and was sentenced to 144 months in federal prison in 2015. Sanamian, who pled guilty in May 2015, was sentenced to 96 months in federal prison and ordered to pay nearly $2 million in restitution.
o Theanna Khou, Los Angeles co-owner of Huntington Pharmacy, was convicted in federal court in 2013 of structuring monetary transactions for her involvement in Mikaelian and Sanamian’s scheme to defraud Medicare and Medi-Cal for prescriptions that were not necessary. Khou received cash that had been used to pay for OxyContin from fraudulent prescriptions issued by Lake Medical Group. Khou was sentenced to 12 months in federal prison.
o Elizabeth Duc Tran, Fountain Valley pharmacist and owner of Mission Pharmacy, was convicted in federal court in 2015 of conspiracy to distribute controlled substances for her involvement in Mikaelian and Sanamian’s scheme to defraud Medicare and Medi-Cal. Tran was sentenced to 24 months in federal prison and surrendered her pharmacist license in 2011.
· The following providers were suspended because their licenses were suspended, surrendered or revoked:
o Clyde Ikuta, Anaheim physician, surrendered his medical license on January 19 after committing gross negligence in his care and treatment of multiple patients by prescribing opioids without prior examinations.
o Jonathan Hechanova, New Mexico physician, surrendered his medical license on January 13 after he entered into a disciplinary stipulation with the New Mexico Medical Board.
o Thanh Nguyen, Washington physician, surrendered his medical license on January 11 after he stipulated with the State of Washington Medical Quality Assurance Commission to informal disposition disciplining him for incompetence, negligence or malpractice.
o Adam Duer, Sacramento physician, surrendered his medical license on January 1 after excessively prescribing narcotics to a patient with a narcotic addiction.
o Bryan Scott Williams, Illinois physician, had his medical license revoked on August 18 due to his license being suspended by the Maryland State Board of Physicians for inappropriate touching of female patients during examinations.
o Renato Guzman, Desert Hot Springs physician, surrendered his medical license this year after acting with gross negligence and unprofessional conduct in the treatment of a patient.
o Robert Andrew Achtel, Sacramento physician, surrendered his medical license this year following an accusation of gross negligence in the care and treatment of patients.
o MaryCharlene Murphy, San Diego physician, had her medical license revoked this year while on disciplinary probation after she committed gross negligence and dishonest and corrupt acts relating to the care of patients.
o Vinay Rawlani, Illinois physician, surrendered his medical license this year after the Illinois Department of Financial and Professional Regulation suspended his medical license indefinitely last year.
o Allen Fujimoto, San Lorenzo physician, surrendered his medical license on December 31, 2016 after he was negligent in the care and treatment of patients, and also aided and abetted the unlicensed practice of medicine.
o Michael Tralla, Colorado physician, surrendered his medical license on December 30, 2016 after being suspended by the Colorado State Medical Board.
o William Schmalhorst, Bakersfield physician, had his medical license revoked on August 4, 2016 for his negligent treatment of a patient.
o Lance Wyatt, Los Angeles physician, had his medical license revoked on July 1, 2016 for gross negligence and sexual misconduct for secretly photographing and videotaping patients without their consent.
o James Michel, Carmel physician, had his medical license revoked on May 25, 2016 after failing to address deficiencies in critical elements that were identified during a facility review.
o Katherine Eunju Lee, Sunland physician, had her medical license revoked in 2016 for gross negligence when she failed to provide her patients notice of her departure from practice.
o Patricia Ann Snyder, Atascadero physician, had her medical license revoked in 2017 for failure to comply with the terms of probation imposed by the Medical Board of California following prior disciplinary proceedings.
o John Gillespie, Upland pharmacist, surrendered his pharmacist license on October 6, 2014 on grounds of unprofessional conduct for incorrectly filing an order that resulted in patient harm.
AB 1244, which went into effect January 1, 2017 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:
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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;
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The provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or
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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 effortsare posted online, including frequently updated lists for physicians, practitioners, and providers who have been issued notices of suspension, those who have been suspended pursuant to Labor Code §139.21(a)(1), and information on lien consolidations and the Special Adjudication Unit.
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Lonce Lamonte, journalist, lonce@adjustercom.com, and the California Department of Industrial Relations, Division of Workers' Compensation; dir.ca.gov
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