New California Bills Fight Fraudulent Workers' Compensation Provisions

Posted By Thomas F. Martin, PLC || 21-Nov-2016

It has long been suspected that the workers’ compensation program in California has been hampered by fraudulent or questionable activity on behalf of dishonest parties. In order to crackdown on the behavior, remove exploitations or loopholes, and generally provide better care for injured workers in the state, Governor Jerry Brown recently signed two new bills.

Fraudsters No more

The first bill prevents doctors and practitioners convicted of certain felonies – mainly those having to deal with theft or fraud – from billing the state’s Medicare program for the malfeasance of workers’ compensation insurers. It was discovered through an investigation that many fraudulent practitioners would go to great lengths to rack up medical bills when “helping” an injured worker. There were cases in which a patient was given $1,600 worth of pain cream they never requested, used, or required; others may have even put patients at risk of further injury, such as when shockwave pain therapy was prescribed without research or reason.

When the insurer rejected to pay for the unnecessary treatments, the fraudulent doctors could file a lien with Medicare. The created legal demand for payment would go into the state’s workers’ compensation system and pack an already overcapacity court, where it would await denial or approval. Investigators believe that uncounted sums of money and time have been lost due to the workers’ compensation system having to deal with and sort through fraudulent liens, rather than dedicating its resources to legitimate cases.

The second bill, which is also now a law, requires all sorts of medical providers to state directly why they are filing for a lien and cite their legal authority when they do so. It should serve as a catch-all system to root out fraudulent medical care providers and felons, which comprised the majority of practitioners that actually use the lien system.

Get Help with Workers’ Compensation Issues

The introduction and approval of the two aforementioned bills underlines the complexities and problems with workers’ compensation filings and cases. An injured worker that only wants to get the care and coverage they need can easily run straight into issues if they do not know what to expect. At Thomas F. Martin, PLC, our Santa Ana workers’ compensation attorney makes it easy to understand and uphold your rights as they pertain to workers’ compensation law.

If you have a problem, we have a solution. Contact us today – case evaluations are free!

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