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 52. DWC Administrative Director George Parisotto issued Orders of Suspension against the following providers: Byong Chun “David” Min of Irvine pled guilty on April 20, 2016 to health care fraud and illegal kickbacks. Min, co-owner and operator of Glory Rehab Team, Inc., which also operated as Dream Hospital and Daesung Clinic in Orange County, was involved in an illegal kickback scheme referring Medicare beneficiaries to co-schemers Marlon Songco, Joseff Sales and Danniel Goyena, knowing that they would bill Medicare for services that were never provided. Sujan Thyagaraj of Roswell, New Mexico, a physician whose medical license was summarily suspended in New Mexico in March 2016 after criminal charges were filed against him for sexual assault on a patient. The Medical Board of California revoked his physician and surgeon’s license on September 23, 2016. Thyagaraj was suspended from the Medi-Cal program on August 29, 2017. Rhonda Singleton of Los Angeles, owner of substance abuse treatment facility Singleton Housing Project, pled no contest in Los Angeles County Superior Court on January 25, 2017 to grand theft of the California Health Care Deposit Fund. Singleton was suspended from Medi-Cal on August 15, 2017. 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. The Department of Industrial Relation’s (DIR’s) fraud prevention efforts are posted online, including frequently updated lists for physicians, practitioners, and providers who have been issued notices of suspension, and those who have been suspended pursuant to Labor Code §139.21(a)(1). The department recently added a new web page with information on lien consolidations and the Special Adjudication Unit. Courtesy: Adjustors.com & William Koressel http://articles.latimes.com/1992-10-18/local/me-1202_1_police-arrest-suspect ...read more

1.    Extended recovery period for injury claimed. 2.    Claimant changed treating physicians without notification. 3.    Added injuries from initial application. Claimant employed for insured less than a month. 5.    Claimant uncooperative. Questionable extent of injury. Claimant retained an attorney, changed doctors and became TTD. 8.    Claimant’s condition has worsened despite treatment and surgery. 9.    Claimant fails to show for scheduled medical appointments. 10. Claimant’s condition worsened after termination for just cause. 11.  Diagnostic findings inconsistent with complaints. ...read more

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