Newsline No.: 2017-89 Date: October 5, 2017
Division of Workers’ Compensation Suspends Eight Medical Providers for Fraud
The Division of Workers’ Compensation (DWC) has suspended eight more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended this year to 46.
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’ compensation 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 November 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 (also known as Edgar Hakobyan) of Glendale was found guilty in federal court on February 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 August 31, 2015 to the Medical Board of California.
Nicole Hlava of Palo Alto, surrendered her medical license on August 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 (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.
DIR protects and improves the health, safety and economic well-being of over 18 million wage earners, and helps their employers comply with state labor laws. DIR’s Division of Workers’ Compensation monitors the administration of workers’ compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers’ compensation benefits.