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Feds: $1.2 Billion in Bills Frozen as a Result of Operation Backlash

  • State: California
  • Topic: WEST
  • - Average time spent on item: 29 minutes
  • - Popular with: Legal
The federal government says its prosecution of a fraud ring based in San Diego that cheated the…

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Diane Sagerian Jul 11, 2019 a 7:07 am PDT

Some AAs and WC treating doctors are complicit and colluding in this WC fraud. But when it gets to the WC settlement phase, and if a QME is ordered, the QME Dr. selected from the panel, that randomly presents 3 QME Drs. to choose from, and is not in collusion and in fact, getting swept up into this fraudulent scheme, in an effort by the criminal AA to win a big settlement. Though AA’s in this scheme get “kickbacks” from treating Drs. they refer to, they make their big money when the WC case settles and they get their cut. The selected QME panel Drs. are unwittingly caught up in this fraud, and in fact, are most likely to detect fraud in their evaluation findings, when they report there is no impairment. I hear it regularly from QME Drs., who often are ordered into depositions by AAs who apply pressure on QME Drs. to change their QME reports. CA is on the wrong side of Federal law regarding it’s “sanctuary” of ILLEGALS, and the presence of ILLEGALS is costing US CITIZENS BILLIONS in increased taxes and insurance premiums (including WC premiums), EVERY year.

Steven Chandler Jul 15, 2019 a 8:07 am PDT

So, not one comment on the fraud these 'patients' posed? They're just 'victims' too? Come on! Anyone who complacently submits to things such as this is just as guilty! Seriously, if I were the employee who may or may not have suffered from an injury and suddenly there is this promise of money and more - who wouldn't go along? Drug mules are bountiful in this region - why not do it this other way where it's much, much harder to get caught? Not buying it. They're just as complicit.

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