View this article online: https://www.insurancejournal.com/news/west/2017/08/15/461201.htm

California Division of Workers’ Comp Suspends 5 Medical Providers for Fraud

California’s Division of Workers’ Compensation has suspended five more medical providers from participating in the state’s workers’ comp system, bringing the total number of suspended providers to 32.

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

• Leovigildo Sayat, a physical therapist in Lompoc who in October 2015 pled guilty in U.S. District Court for the Central District of California as a co-conspirator in a $15 million scheme to defraud Medicare by billing for physical therapy services never provided.
• Alexander Kiev Martinez, a durable medical equipment provider in El Centro, who in April 2016 pled guilty in San Diego Superior Court for referring patients in a bribery scheme involving $25 million in improper claims for medical services and devices billed to California workers’ compensation insurance companies.
• Robert Gogatz, a chiropractor in Murrieta who in May pled guilty in Riverside Superior Court to 16 counts of insurance fraud.
• Robert Alva Rose, a physician in Irvine who pled guilty in Orange County Superior Court on Sept. 15, 2015 to two misdemeanors related to his qualifications as a medical provider.
• Paul Barkal, a physician in San Diego who surrendered his license to the Medical Board of California on Oct. 17, 2005.

Assembly Bill 1244 requires the DWC administrative director to suspend any medical provider, physician or practitioner from participating in the workers’ comp 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.

Related:

• Workers’ Comp Lien Proceedings in California Scheduled for Drobots
• California Division of Workers’ Compensation Suspends Two, Including Drobot
• California Department of Workers’ Comp Says 441K-plus Lien Declarations Filed
• Other Calderon Pleads Guilty to Bribery as Part of Workers’ Comp Scheme
• Worker’s Comp Lien Filing Rules Filed with California Secretary of State
• California DIR Releases Overview of Upcoming New Laws