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Prosecutors Announce More Indictments in Alleged San Diego Fraud Ring

By Greg Jones (Deputy Editor)

Friday, January 29, 2016 | 8074 | 0 | 3 min read

The San Diego District Attorney's Office on Thursday announced the indictment of 13 people allegedly involved in a scheme to pay kickbacks to the owners of chiropractic clinics in exchange for the referral of workers' compensation patients. At the same time, the U.S. Attorney's Office announced three patient recruiters and four affiliated corporations were also indicted on federal charges of referring injured workers to chiropractors on the condition that the chiropractors meet a quota for scheduling those patients for imaging tests and durable medical equipment supplied by specif...

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Comments

Thomas Maupin Nov 3, 2016 07:58 AM

Isn't the chiro's last name Ringler instead of Rigler?

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John A. Don esq. Nov 3, 2016 07:58 AM

I have started getting PQME's which continuously send the worker out for FCE's and diagnostics. These procedures delay the reporting and resolution of the claims. Certainly, if done en masse they would generate a tidy profit to the providers.

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Hector Lopez Nov 3, 2016 07:58 AM

Yes, agree with that. Just received a PQME from LA chiro with FCE charge of $1850. Conveniently the FCE was done in the DC's office.

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Jerry Wells Nov 3, 2016 07:58 AM

Simply the latest in a string of despicable acts demonstrating the pervasiveness of greed in this system.

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Alexander Zaks Nov 3, 2016 07:58 AM

Please give me the money the carriers make by cheating injured workers, medical providers, and the employers that they insure ANY day. There is a reason, and really one reason only, why the prosecutors go after the people they do; those who have the gold make the rules (and hire the people who enforce them)

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David Stein Nov 3, 2016 07:58 AM

I agree that the prosecutors don't go after carriers. THe carriers are the prosecutors though. Don Marshall (Zenith), Vern Steiner (SCIF) and others run DOI fraud operations and hand out cash to district attorneys. No chance of them being investigated even though mgmt. at both companies have well documented multi million $ fraud schemes in operation as we speak. The only hope is that one of the providers indicted will know enough to cause trouble.

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Mary Huckabaa Nov 3, 2016 07:58 AM

The carriers are required to pay into the Fraud commission. They are also required to investigate and report fraud. Steiner is pretty new to State Fund. I seriously doubt he has "well documented multi million $ fraud schemes in operation". I'd like to see that "documentation".

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Mary Huckabaa Nov 3, 2016 07:58 AM

Then why are they still allowed to come to the WCAB District Offices and prosecute their liens? Really, someone tell me how someone can plead guilty to fraud and then continue to show up in court and try to collect liens?

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David Torres Nov 3, 2016 07:58 AM

Please elaborate, I have heard about this but in in a general way. I would really appreciate understanding your comments as I have numerous clients that have had issues with entities such as Zenith. Thank you

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David Stein Nov 3, 2016 07:58 AM

The money that goes to the Fraud Commission comes out of premiums but is really a surcharge collected by carriers at the direction of the state rather than money that is being paid out of their pockets. The FAC is an arm of the govt. but the way it is set up with carriers directing statewide fraud prevention efforts it is essentially giving those people a shield from the law. It's the root of "pay to play" in the CA WC system. If a doc wants to charge excessively for PT without trouble he sets up a company for the spouse, brother, or even directly for someone at a carrier that provides braces. The doc then hands out braces to the claimants along with their PT. He has little opposition in getting overly paid and in return pays handsomely for the braces "provided" by the sham brace company, generally known as a kickback. If you want to exploit compound pain creams you also hand out $500 milk and pepper tablets. If you want to do lots of MRI's hire the right MRI maintenance company and you will be fine.

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