Fraud Report, California Medical Evaluators

Fraud Report

Fraud Report

On February 20, 2018, the California Department of Worker’s Compensation (DWC), issued a fraud report, where it suspended 20 medical providers for fraud.  That brings the total number of medical providers suspended by the DWC to 247, you can review the complete list of suspended providers here.

The Division of Workers’ Compensation (DWC) works to identify and prevent fraud in the workers’ compensation system, as well as wage theft and other types of fraud that affect California’s workers and law-abiding employers and this latest fraud report indicates that they are making progress.

You can read the full  California Department of Industrial Relations News Release here, which details the specific medical providers that have been suspended for fraud.

DWC fraud from medical providers in the system can come in many forms, however, the Department of industrial relations has indicated that billing for inappropriate or unnecessary treatment, submitting bills with improper medical codes and accepting bribes from indigent individuals to be “injured worker” patients are the more common forms.

To combat these types of fraud in the State of California, important new tools have been put into place.  These tools included a new automatic lien stay provision as well as a process for suspending providers from the workers’ compensation system, and in some cases, consolidating and disposing of their liens. Fraud in the system demonstrates that there are highly educated professionals willing to ripoff the system for personal gain.  As a result, it is important to be aware of any fraud activity in the system and ensure everyone operates under the same rules and regulations.

We at California Medical Evaluators only work with highly ethical physicians that are interested in improving the lives of workers in the state of California.  You can review the complete list of Physicians that we work with in the QME Physician Directory.


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