Workers' compensation fraud always seems to be something in the news in California. It is…
Countless people throughout Southern California depend on workers compensation benefits to account for lost time from their jobs due to work-related injuries. Unfortunately, there are many people within the system who engage in unethical and abusive practices. Ultimately, it is the people who need the benefits who are hurt the most. Recently, a San Diego jury convicted Beverly Hills radiologist Dr. Ronald Grusd for his role in a huge fraud scheme. Grusd received kickbacks for referrals, allowing him to bill insurance companies for an excess of $25 million for medical services that were never needed.
The case involving Grusd is one of the worst. Since 2009, he operated the California Imaging Network Group with medical practices located in Los Angeles, San Diego, Santa Ana, Fresno and Calexico. It took a San Diego jury one week to find Grusd guilty of all counts including conspiracy, health care fraud and honest services and wire fraud. Among the most serious was bribing physicians to recommend unnecessary health services to patients who filed workers’ compensation claims. Among the service referrals were for:
Once the services were provided, Grusd would then request reimbursement from insurance companies. During that time period, Grusd and his health network billed staggering hundreds of millions of dollars from California’s workers’ compensation system. To deceive insurance companies, Grusd used a shell company, called Willow Consulting, to pay kickbacks. Each check was labeled “professional services” to conceal any trace of bribery. In total, Grusd wrote out checks exceeding $100,000 in bribes to cover hundreds of patients who filed workers’ compensation.
Widespread abuse and corruption in the state’s workers’ compensation system has long been a problem. To combat the problem, California officials launched a large crackdown on medical insurance fraud known as “Operation Back Lash”. Since the campaign was launched in November 2015, nearly 40 healthcare providers, physicians and corporations have been charged with federal and state crimes. In the Grusd case, five others were also charged with receiving bribes. Thus far, four have pleaded guilty and are cooperating with authorities.
When filing a California workers’ compensation claim, the last thing you should ever have to worry about is any wrongdoing by your medical provider. Physicians and healthcare providers have a responsibility to provide the best possible care. Yet, far too many physicians and healthcare companies try to take advantage of unsuspecting injured workers. Over the years, the Van Nuys workers’ compensation attorneys at Koszdin, Fields, Sherry & Katz have utilized an aggressive and comprehensive approach to protecting the rights of each client. From the time a client visits their law office for their initial consultation through the time a case is a settlement, you can always count on their legal to be in your corner. It is part of their complete commitment to always look out for the best interest of injured workers. Whether your claim has been underpaid or denied, contact their Van Nuys law office today and schedule a consultation to discuss your case.