Comp Regulators Suspend 178 Medical Providers in 2022

Tuesday, October 4, 2022 | 0

The California Division of Workers’ Compensation and its Anti-Fraud Unit suspended 178 medical providers during the first eight months of 2022.

Providers are suspended from the workers’ compensation system when they have been convicted of fraud-related crimes, have been suspended from the Medicare or Medicaid programs due to fraud or abuse, or have lost their professional license, according to a statement.

Since 2017, a total of 649 providers have been suspended from participating in California’s workers’ compensation system.

The DWC has also initiated new lien consolidation cases estimated at $75 million for providers who were convicted of fraud-related crimes in 2022. During lien hearings, medical providers have an opportunity to prove the billing is legitimate. If they are unable to produce such evidence, the liens are dismissed.

A total of 63,000 liens have been dismissed since 2017 with a collective value of nearly $775 million.

There are currently 86 criminally charged providers with 516,000 liens designated as stayed. The stays prevent criminally charged providers from seeking payment for their liens while the criminal case is pending.

A list of suspended providers is available here.

Business Insurance is a sister publication of WorkCompCentral. More stories are here.