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California Division of Workers' Compensation (DWC) Suspends Eight Medical Providers for Fraud or Loss of License
By Lonce Lamonte and Newsline from the California Department of Industrial Relations - April 2, 2018

The Division of Workers’ Compensation (DWC) has suspended eight more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended to 242.

DWC Administrative Director George Parisotto issued suspension orders against the following providers:

The following five providers worked as substance abuse recovery counselors at Atlantic Health Services of Long Beach, a drug and alcohol recovery program serving high school and middle school students in Los Angeles County. They were convicted in federal court in 2014 for their participation in an illegal scheme to defraud Medi-Cal by falsifying documents and illegally billing for services that were not provided, unnecessary and/or not provided at licensed facilities. Dr. Leland G. Whitson, the program’s director, along with nine other providers were also convicted for their role in the scheme.

·Helsa Casillas of Los Angeles also directed counselors she supervised to collect student signatures on sign-in sheets for group counseling sessions that the students did not attend

·Tamara Diaz of Whittier

·Irma Talavera of Bellflower

·Laura Vasquez of Pico Rivera

·Arthur Dominguez of Glendale

The following providers were suspended because their licenses were surrendered, suspended or revoked:

  • Carl Gene Gold, Springfield, Illinois physician, had his license revoked in 2017 after the Illinois Department of Financial and Professional Regulation suspended his license indefinitely for diverting controlled substances from a hospital for personal use.
  • Andrew Gregory Monroy, Santa Barbara physician, had his license revoked in 2015 after he was found grossly negligent in the care and treatment of patients and failing to maintain adequate and accurate records.
  • Debra Janine Thomas, Richlands, Virginia physician, had her license revoked in 2017 after the Illinois Department of Financial and Professional Regulation refused to renew her license based on a finding that she was unable to practice with reasonable skill and safety.

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, lonce@adjustercom.com, and the California Department of Industrial Relations' Newsline; dir.ca.gov  

 
 

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