Mother, Son Accused of Running Illegal Occupational Health Clinic

Friday, April 28, 2017 | 0

Northern California prosecutors allege a mother and son — neither of whom had medical licenses — illegally operated an occupational health clinic in South San Francisco that was paid $4.5 million to treat injured workers.

Matthew H. Skinner

The San Mateo County District Attorney’s Office charged Paula C. Skinner, 74, and her son, Matthew H. Skinner, 47, with multiple felony counts of insurance fraud, grand theft and practicing medicine without a license. From 2010 until 2016, the Skinners owned Pacific Occupational Health Clinic despite the fact that they were not licensed medical doctors, prosecutors allege.

“California law requires any medical corporation be owned at least 51% by a doctor, and 49% can be owned by people with other degrees,” San Mateo Chief Deputy District Attorney Karen Guidotti said. “Neither (Paula or Matthew) were a medical doctor and they owned this corporation called Pacific Occupational Health Clinic in South San Francisco. It was lay people owning a medical practice. Then they were accepting prescriptions and recommendations from other people, and fulfilling them.”

Guidotti also said that on at least one occasion, Matthew Skinner took X-rays of a patient.

The Skinners were both arrested Tuesday and are being held on bail of $11.9 million. Both are charged with 20 counts of insurance fraud for filing false claims with five carriers, including Liberty Insurance, Travelers Insurance, the Hartford, State Compensation Insurance Fund and Intercare Holdings Insurance Service, according to the complaint filed April 13. Both also face 10 counts of grand theft and four counts of practicing medicine without a license.

Matthew Skinner was booked into the San Mateo County jail and made his first court appearance Wednesday. He did not enter a plea and proceedings were carried over to Monday. Paula Skinner was booked into the Sonoma County Jail and hasn’t made her first court appearance.

Paula Skinner is a licensed physical therapist, but the California Corporation Code Section 13401.5 limits physical therapists to owning 49% of a medical corporation.

There are no records of disciplinary action against her license listed on the Department of Consumer Affairs website.

Matthew Skinner describes himself as an “operations executive” on his LinkedIn profile, and describes his current job as being chief executive officer and director of operations for Injury Control Systems and Injury Management Group.

He also says in his online profile that he has worked for the medical companies since January 2004. He claims to have “led the organizational turnaround to profitability from losing $20k/month to annual revenues of $5.9 million with annual net profit in excess of $1 million.”

According to the U.S. Centers for Medicare and Medicaid Services website, Injury Control Systems is an alias of Pacific Occupational Health Clinic. Injury Management Group is an alias of Action Therapeutics, according to the CMS website. It is located at the same address as Pacific Occupational Health Clinic on South Linden Avenue in South San Francisco, and it is run by Paula Skinner.

Records from the California Secretary of State show Matthew Skinner registered Injury Control Systems in June 2005.

The felony complaint says Dr. Vahe Sarkissian notified authorities about the allegedly illegal medical clinic. In sections of the complaint that explain why the charges should not be barred by the statute of limitations, it says violations were “not discovered until March 2015 by Dr. Vahe Sarkissian while working at POHC, and he reported the crime to the FBI in December 2015.”

WorkCompCentral was not able to locate Sarkissian on Thursday. A person who answered a call to the phone number linked to his National Provider Identification, and listed on the CMS website, said it was a wrong number.

The California Secretary of State’s website identifies Sarkissian as the agent for service or process — the primary contract for legal and other documents on behalf of a business — for Pacific Occupational Health Clinic.

The California Medical Board is currently moving to revoke or suspend Sarkissian’s license over allegations that he forged prescriptions for controlled substances using prescription pads stolen from other doctors at Pacific Occupational Health Clinic. The board’s accusation filed in February says Sarkissian forged prescriptions for benzodiazepines or amphetamines that he tried to pick up at pharmacies on three occasions last year. He was arrested at Pacific Occupational Health Clinic on Aug. 26.

Allegations against Pacific Occupational Health Clinic are an interesting twist on a somewhat common scam to churn bills in California’s workers’ compensation system.

The typical scheme has been what’s often referred to as an “MD-DC” clinic, or "doc in a box." On paper, a licensed doctor owns 51% of these corporations, and a chiropractor owns the remaining 49%. But in the handful of cases that have been prosecuted throughout the state it was alleged that the chiropractor actually ran the company and the doctor was just a figurehead paid a monthly fee to make the operation appear legitimate.

In November 2010, a Kern County judge sentenced Shawn Dodd to six years in prison while her husband, James Dodd, was sentenced to one year in jail for running medical clinics in Central California without a license and billing for services that weren’t provided.

In 2011, a federal jury in Sacramento found Dr. Ramanathan Prakash guilty on one count of conspiracy to commit health care fraud and three counts of health care fraud for submitting false bills to Medicare. Prakash, who was a qualified medical evaluator at the time, owned 51% of Golden State Neuro Medical Association.

Back in 2002, prosecutors in Monterey County shuttered medical clinics run by chiropractors Steven Thompson and his wife, Aster Kifle-Thompson. The Thompsons operated Peninsula Medical Group and paid a doctor a monthly fee of $250 to serve as the owner, according to court documents.