|California Department of Workers' Compensation Suspends Seven Medical Providers for Fraud or Loss of License|
By Lonce Lamonte and the Department of Industrial Relations' Newsline - January 11, 2018
The Division of Workers’ Compensation (DWC) last week suspended seven more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended to 166. The providers were suspended for fraud or other criminal actions, or the loss of their license.
DWC Administrative Director George Parisotto issued suspension ordersagainst the following providers:
· David Wayne Fish, Los Angeles businessperson, was convicted in Los Angeles County Superior Court in 2010 for receiving compensation or inducement for the referral of clients. Fish organized dozens of lawyers and doctors to steer more than 4,000 cases to preferred medical providers in order to run up high bills. Fish was ordered to pay $10,000 in restitution and approximately $390,000 in unpaid taxes.
· The following providers participated in an illegal prescription mill that generated OxyContin prescriptions that the clinic’s patients did not need and submitted claims to Medicare and Medi-Cal for services that were medically unnecessary, not ordered by a doctor and/or not performed:
o Perry Tan Nguyen, Huntington Beach pharmacist, was convicted in federal court in 2014 of structuring financial transactions to evade reporting requirements. Nguyen was sentenced to 6 months in federal prison and surrendered his pharmacy license in 2017.
o David James Garrison, Los Angeles physician assistant, was convicted in federal court in 2014 of conspiracy to distribute controlled substances. Garrison was sentenced to 120 months in federal prison and had his medical license revoked in 2015.
o Matthew Cho, Irvine pharmacist, was convicted in federal court in 2015 of conspiracy to distribute controlled substances. Cho had his pharmacy license revoked in 2017.
· The following providers were suspended because their licenses were suspended, surrendered or revoked:
o Boyao Huang, San Marino physician, was convicted in federal court in 2016 of health care fraud for his involvement in a scheme to defraud Medicare and Medi-Cal by creating fraudulent diagnoses of patients and falsely certifying that they were terminally ill in order to bill for hospice-related services. Huang was ordered to pay more than $1.3 million in restitution and surrendered his medical license in 2016.
o Eleanor Mela Santiago, Irvine physician, was convicted in federal court in 2015 of conspiracy to commit health care fraud for her involvement in a prescription mill that generated prescriptions for unneeded OxyContin and submitted claims to Medicare and Medi-Cal for medical services that were unnecessary or were never performed. Santiago was sentenced to 20 months in federal prison and ordered to pay more than $3.7 million in restitution. Santiago surrendered her medical license in 2011.
o Alvin Mingczech Yee, Irvine physician, was convicted in federal court in 2013 for illegal distribution of controlled substances. Yee was sentenced to 135 months in federal prison and his medical license was revoked in 2016.
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:
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 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, firstname.lastname@example.org, and the California Department of Industrial Relations, Division of Workers' Compensation; dir.ca.gov