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Ronald Grusd, M.D., a Beverly Hills, California, radiologist, has now been suspended by the California Department of Workers’ Compensation following numerous years of fraudulent activity relative to the California workers’ compensation system.  He was convicted by a federal jury for fraud and bribery on December 12, 2017 together with two of his corporations. 

A complex capping scheme also involved now suspended providers Steven Rigler, Carlos Arguello, Fermin Iglesias, and Alexander Kiev Martinez.  Dr. Grusd and his co-conspirators submitted claims in excess of $25 million for services procured through the payment of bribes. 

Back in 2011, on August 25^th, the LAPD (Los Angeles Police Department) raided the medical offices of Dr. Grusd at 8641 Wilshire Boulevard, Suite 105, in Beverly Hills.  The practice was known at the time as Advanced Radiology of Beverly Hills.

That morning an agent indicated that Advanced Radiology had a meeting scheduled with Medstar Funding, a Medical Lien Financial Group, but that he and others got a text message stating the meeting had been cancelled.  Medstar Funding had been looking into buying 10 million dollars’ worth of Advanced Radiology’s receivables which were in the form of workers’ compensation liens.

Advanced Radiology previously had faced allegations by the federal government for Medicare fraud.  The company in July 2010 paid $647,000 to settle that they filed false claims with Medicare for unnecessary radiology tests.  A civil law suit was dismissed after this settlement which had alleged Grusd had engaged in a scheme to bill Medicare for unnecessary tests from 1999 to 2002. 

Dr. Grusd and his administrator, Gonzalo Paredes, and the corporation were indicted by a federal grand jury in November 2015 when the U.S. Attorney’s Office and the San Diego District Attorney’s Office, working in conjunction with the Federal Bureau of Investigation and the California Department of Insurance, announced multiple arrests arising from “Operation Back Lash” – a long-term, proactive health care fraud investigation targeting corruption and fraud in the California Workers’ Compensation system that is on-going. 

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:

• 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.

lonce@adjustercom.com, Lonce Lamonte, journalist