Insurance Fraud NEWS
California suspends 8 providers for alleged comp cons
October 05, 2017, Beverly Hills, CA
The Division of Workers’ Compensation has suspended eight more medical providers from participating in California’s workers’ comp system, bringing the total number of providers suspended this year to 46.
The suspensions were made possible by the passage last year of Assembly Bill 1244, which requires the DWC administrative director to suspend any medical provider convicted of a crime involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ comp system, a patient, or related types of misconduct.
DWC Acting Administrative Director George Parisotto issued orders of suspension against the following providers:
Abraham Khorshad of Beverly Hills, investor in Aspen Medical Resources and co-conspirator with Jeffrey Campau and Landen Mirallegro, who were suspended from the workers’ comp system last month. Khorshad and his co-defendants pled guilty in Orange County Superior Court on May 5 to medical insurance fraud for their involvement in an overbilling scheme in which they defrauded insurance companies of more than $70 million. The three providers agreed to pay more than $8 million in restitution to several insurers and self-insured employers, and to voluntarily dismiss liens of nearly $140 million.
Joseff Sales of Buena Park, physical therapist, and Danniel Goyena of Whittier, physical therapist assistant, pled guilty in federal court on Nov. 17, 2015 for paying illegal kickbacks as part of a Medicare fraud scheme. Both providers were co-owners and operators of Rehab Inc., Rehab Dynamics Inc. and Innovation Physical Therapy Inc. They surrendered their licenses and were each sentenced to 51 months in federal prison. The pair were ordered to pay restitution of up to $7.9 million.
Edgar Pogosian of Glendale was found guilty in federal court on Feb. 26, 2016 for money laundering and conspiring to commit money laundering. He took part in a health care fraud scheme to bill Medicare for equipment and tests that were not medically necessary and sometimes were not provided. He received 150 checks and laundered over $700,000 in health care fraud proceeds. Pogosian was sentenced to 18 months in federal prison.
Timothy Martin of Benicia, osteopathic physician and surgeon, had his medical certificate revoked on June 1, 2015 by the Medical Board of California.
Alex Abbassi of Tarzana, surrendered his physician and surgeon’s certificate on Aug. 31, 2015 to the Medical Board of California.
Nicole Hlava of Palo Alto, surrendered her medical license on Aug. 11, 2016 to the Medical Board of California.
Maher Abadir of Modesto, surrendered his medical license on May 20, 2016 to the Medical Board of California.
AB 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 any of the following is true: They were onvicted 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 misconduct; they were suspended due to fraud or abuse from the Medicare or Medicaid programs; or the provider’s license to provide health care has been surrendered or revoked.
Source: Insurance Journal