Several doctors, attorneys, and other parties were charged for their involvement in a medical scheme that was devised as an attempt to fraud the California state workers’ compensation system.
A false workers’ compensation help line was set up as a way to lure injured workers into the scheme: The workers thought the service would connect them with doctors to treat their occupational injuries, but the doctors they were referred to were engaged in the plot of providing false medical care for profit.
The main targets of the scheme were injured migrant workers who work in both California and Mexico throughout the year. The workers discovered one of the several fraudulent companies through advertisements, and would call with the hope of receiving workers’ compensation benefits. The goal for the perpetrators of the scheme was to incur the highest medical bills they possibly could, and as a result would receive maximum payouts when the workers’ compensation cases were settled.
To maximize profits, doctors would require patients to complete unnecessary tests and treatment — according to an FBI report on the case, “a patient with a simple knee injury might be referred for urine tests, DNA tests, sleep studies, unnecessary medical equipment, and numerous MRIs on body parts in addition to the injured knee. This happened with hundreds of patients.” Medical providers would then bill the services at extremely high prices, and involved doctors, attorneys, and others would receive a cut.
Through the course of the scheme, the perpetrators managed to garner over $200 million form the state’s workers’ compensation system, as well as from insurance providers. Thirty-two people have been found guilty for their involvement so far.
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