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CA DWC Suspends Three Medical Providers for Fraud

October 12, 2017 - WorkCompWire

San Francisco, CA – The Division of Workers’ Compensation (DWC) has suspended three more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended this year to 49.

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 September 4, 2013 to visa fraud, and surrendered his Physician’s and Surgeon’s Certificate on September 9, 2014. Broomberg knowingly made false statements under penalty of perjury on visa applicants’ Report of Medical Examination and Vaccination Record forms (United States Citizenship and Immigration Services Form I-693) without performing the required tests and examinations.
  • Robert E. Brizendine of San Diego, psychologist, surrendered his Psychologist’s License to the California Board of Psychology on March 20, 2014.

AB 1244 (Gray and Daly), which went into effect January 1, introduced new changes to the workers’ compensation system and requires the division’s Administrative Director to suspend any medical provider, physician or practitioner from participating in the workers’ compensation 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.

Source: CA DWC

Filed Under: Claims, Legal, & Compliance News, Industry News, Top Stories, Workers' Compensation

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