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DWC Posts Ambulance Fee Schedule Update to Conform to Changes in Medicare Payment System
By Press Release - July 29, 2014

The California Division of Workers’ Compensation has adopted an order adjusting the ambulance services section of the official medical fee schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1. The effective date of the changes is August 1, 2014, for ambulance services paid for under the California workers’ compensation OMFS.


DWC Commences Rulemaking Action to Delay ICD-10 Implementation Until October 1, 2015
By Press Release - July 25, 2014

The Division of Workers’ Compensation (DWC) has posted proposed changes to a regulation and to the Medical Billing and Payment Guide to postpone the current ICD-10 compliance date of October 1, 2014 for one year, to October 1, 2015.

The International Classification of Diseases – 10th Revision, Clinical Modification (ICD-10-CM) and the International Classification of Diseases – 10th Revision, Procedure Coding System (ICD-10-PCS) were adopted in February 2014 with an implementation date to coincide with the Health Insurance Portability and Accountability Act (HIPAA) implementation date.


American Claims Management Now Handling GL & Excess Claims For Golden Insurance Company RRG
By Lonce LaMon - July 24, 2014

American Claims Management (ACM), based in San Diego, California, has been selected by Golden Insurance Company Risk Retention Group (RRG) to handle its general liability and excess liability claims. The effective dates of the claim handling date back to beginning May 1st 2014.
  
Golden Insurance Company RRG has provided insurance for builders, contractors, and artisans for the past 13 years. Underwritten by Program Administrator OnPoint Underwriting, Golden Insurance offers both primary commercial liability and excess liability coverage. 

Sim Hoffman, M.D. Arraignment In Orange County For Work Comp Billing Fraud Trailed To September 11th
By Lonce LaMon - July 21, 2014

Just this past Friday, in the morning of July 18th 2014, Sim Hoffman, M.D., a radiologist from Buena Park, California, and Thomas Heric, M.D., a neurologist based on the west side of Los Angeles, appeared in courtroom C-57 in the Orange County Superior Courthouse.   In response to the 159 count complaint filed against them in January of 2014 by the Orange County District Attorney’s office, Hoffman appeared looking quite well in a lime-hued cream colored suit and a red tie.   Heric, the big man, also appeared and looked well in a very dark blue suit and blue tie accompanied by his faithful wife, in black, who always accompanies him to court.  
 
This complaint is for alleged offenses related predominantly to workers’ compensation billing fraud for sleep studies and single fiber EMGs in the realm of 18 million dollars.   The arraignment was predicted by the DA to be done and over on Friday, however it didn’t happen.  
 
Shaddi Kamiabipour, Deputy District Attorney, wearing a becoming black dress with red polka dots on the sleeves and shoulders, spoke up to Judge Robert R. Fitzgerald as she stood before the bench in the tiny, crowded court room filled with a preponderance of under-educated, non-white collar members of the Santa Ana ‘hood.   This court room, C-57, only has four rows with seven seats in each row; thus, Hoffman and Heric were asked to wait outside in the hallway until they were called.   The room immediately after being opened jammed up with people overflowing into the one aisle.  A corpulent man wearing a golf shirt cordoned off 5 seats in the front row.   There was a stark contrast between Hoffman and Heric and the rest of the defendants from other cases. 

More News

July 17, 2014 - Report on Workers’ Comp Reforms of SB 863 Shows Progress, Challenges in Enacting Law’s Wide-Ranging Changes

July 14, 2014 - Aspen Medical Resources’ Defense To File A 995 Motion To Dismiss In Orange County 36 Million Dollar Workers’ Compensation Fraud Case. Next Court Appearance Set For August 29th 2014.

July 10, 2014 - Division of Workers’ Compensation Posts Corrected Spanish Language Time of Hire Pamphlet

July 7, 2014 - Orange County DA Relentless Against Workers' Comp Fraud. New Case Indictment Soon Coming To Court. Aspen Medical Returns To Court Room This Friday, July 11.

July 2, 2014 - DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services/Non-Physician Practitioner Services)

July 1, 2014 - The Hartford To Release Second Quarter Earnings July 30th. Sells Hartford Life Insurance KK To Orix Life.

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