Insurance Fraud NEWS
California boots 3 providers from state comp system
October 16, 2017, San Diego, CA
The California Division of Workers’ Compensation has suspended three more medical providers from participating in the state’s workers’ comp system, bringing the total number of providers suspended this year to 49.
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:
Samuel H. Albert of Tustin, psychiatrist, pled guilty in the U.S. District Court for the Central District of California on June 20, 2016 to conspiracy to commit health care fraud. Albert had submitted over $4.2 million in fraudulent claims to the Federal Office of Workers’ Compensation Programs.
Barry Julian Broomberg of San Diego, physician and owner of La Jolla Medical Associates, pled guilty in the U.S. District Court for the Southern District of California on Sept. 4, 2013 to visa fraud, and surrendered his Physician’s and Surgeon’s Certificate on Sept. 9, 2014. Broomberg made false statements under penalty of perjury on visa applicants’ medical forms without performing the required tests and examinations.
Robert E. Brizendine of San Diego, psychologist, surrendered his license to the California Board of Psychology on March 20, 2014.
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 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 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