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California DWC Posts Adjustments to Official Medical Fee Schedule (DMEPOS)
By Press Release - September 17, 2014

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) section of the Official Medical Fee Schedule to conform to changes in the Medicare payment system as required by Labor Code section 5307.1. The update includes all changes identified in Center for Medicare and Medicaid Services Change Request (CR) number 8865.


California Division of Workers' Compensation Posts Updated Physician Fee Schedule FAQs Regarding Physician-Dispensed Durable Medical Equipment
By Press Release - September 17, 2014

The Division of Workers’ Compensation (DWC) has been receiving an increasing number of inquiries regarding the reimbursement of durable medical equipment (DME) dispensed by physicians. Some members of the public have asked whether the physician fee schedule Medically Unlikely Edits (MUE) bar payment to a physician for DME dispensed to his or her patient.


Landmark Medical Defendants Plead Not-Guilty In Orange County. Southern California Radio Station KPCC Publishes FBI Recordings.
By Lonce LaMon - September 15, 2014

All fifteen defendants pled not-guilty in the Landmark Medical Management compound medication workers’ compensation fraud case in Orange County Superior Court last Friday morning, September 12th 2014.  
 
This 105 million dollar workers’ compensation medications rip-off scandal involved doctors who were paid over 25 million dollars in kick-backs to prescribe compound cream pain medications.  One of the toxic creams is alleged to have caused the death of an infant. 
 
No warnings of the toxicity were given by the doctors or written on the tubes containing the creams.   The creams cost about $70 for each vial while the insurance carriers were billed between $1200 and $1800 per vial.
  
Kareem Ahmed, the owner of Landmark Medical, was there in court room C-45 in his signature dark suit with a white, open-collared shirt.   His lawyer, Benjamin Gluck, led the arraignment for all the defendants. 
 

Sim Hoffman, M.D.'s Lawyers Filing Demurrer In Orange County Superior Court; arraignment on this $18 million workers' comp fraud case continued to November 7th 2014.
By Lonce LaMon - September 13, 2014

Sim Hoffman, M.D. was a lone figure outside the court room on the morning of September 11th, Thursday, sitting on the bench on the opposite wall from C-57 in the Orange County Superior Courthouse.  He sat there alone in a beige suit with a soft red tie and a pair of shiny brown loafers with tassels.
 
Dr. Hoffman, a radiologist who ran a sleep disorders medical center in Buena Park, California, back when the investigations began against him prior to 2011, stands accused in this latest January 2014 filing by the Orange County District Attorney of approximately 18 million dollars in workers’ compensation billing fraud.  He is accused along with co-defendant, Thomas Heric, M.D., a neurologist, who allegedly evaluated sleep tests on patients which were found by investigators and the insurers to have no medical value.  It is alleged these evaluations were sheer fantasy.

More News

September 10, 2014 - Drop Seen in Injuries to Alberta Workers

September 8, 2014 - Ohio Chiropractor Ordered To Pay Nearly $400,000 In Restitution For Workers’ Compensation Fraud. Voluntarily Decertifies Himself As An Ohio Workers’ Comp Health Care Provider.

September 3, 2014 - AAA Copy, LLC Given Probation And Ordered To Pay Restitution In San Bernardino

September 3, 2014 - The National Underwriter Company to Publish The Zalma Insurance Claims Library

August 29, 2014 - Kareem Ahmed Arraignment A Crowd Scene In Orange County Superior Court. Nearly 12 doctors now stand to lose their licenses.

August 26, 2014 - Kareem Ahmed's Toxic Compound Pain Medication Was Distributed To Claimants Without Warning. Arraignment For 15 Defendants Continued To September 12th 2014.

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