National Hispanic Heritage Month initially began as a weeklong celebration in 1968, under President Lyndon Johnson. In 1988, President Ronald Reagan extended this from September 15 through October 15, to celebrate the history, cultures, and contributions of Americans whose ancestors came from countries of Hispanic origin. The September 15 start date is significant because it is the national Independence Day of Nicaragua, Guatemala, Costa Rica, Honduras, and El Salvador. Mexico celebrates its Independence Day on the 16th, with celebrations following in Chile and Belize on the 18th and 21st, respectively.
Mullen and Filippi is pleased to recognize and support people of Hispanic descent, as we appreciate the diversity that each culture brings to the workers’ compensation community and to our nation.
DWC ISSUES NOTICE TO RE-ADOPT EMERGENCY REGULATION § 46.3
On October 4, 2022, the Division of Workers’ Compensation (DWC) issued its notice of intent to re-adopt and extend Emergency Regulation Section 46.3, which allows medical-legal evaluations to be performed via telemedicine by electronic means, where the physician and the injured worker are not in the same physical space during the examination. The regulation is currently set to expire on October 18, 2022.
DIR SUSPENDS 178 PROVIDERS FROM THE WC SYSTEM SO FAR THIS YEAR
On September 29, 2022, the Department of Industrial Relations (DIR) announced that its DWC and Anti-Fraud Unit suspended 178 medical providers in the first eight months of the calendar year.
According to the DIR’s Newsline article, 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.”
The DWC has initiated new lien consolidation cases for the numerous providers that were convicted of a fraud-related crime in 2022.
During the lien proceedings, the medical providers will have the opportunity to prove that their billing is legitimate. If they are unable to do so, their liens will be dismissed.
According to the DIR, there are currently 86 criminally charged medical providers and 516,000 liens designated as stayed, which prevents these providers from seeking recovery while the cases are pending. A list of these providers can be accessed through the link below.
PROMINENT SOUTHERN CA APPLICANT ATTORNEY CONVICTED OF FRAUD
On June 5, 2017, the Orange County District Attorney announced charges against 10 attorneys and six cappers, resulting from a multi-million-dollar workers’ compensation referral scheme which exploited persons in predominantly Spanish-speaking communities. Mr. Jon Woods of Cypress was among the attorneys charged.
According to the charges, Carlos Arguello III was accused of forming Centro Legal International and securing unlawful referral contracts with 20 to 40 workers’ compensation attorneys. Arguello was accused of requiring the attorneys to use several other companies owned or controlled by Arguello and Edgar Gonzales, including copy services, document managing services and scheduling services. The attorneys were accused of paying a monthly fee to cappers to deliver monthly targets.
On August 1, 2022, following a jury trial, Mr. Woods was convicted of violating the following Penal Code sections:
- 182(a)(1) (conspiracy to commit the crime of referring of clients for compensation, a violation of Labor Code Section 3215), a felony and a crime that may involve moral turpitude.
- Penal Code Section 549 (soliciting, accepting, or referring business to or from anyone with knowledge or reckless disregard, whether the person for or from whom the referral is made, intends to violate Penal Code Section 550 or Insurance Code Section 1871.4), three counts, felonies and crimes which may involve moral turpitude.
- Penal Code Section 550, subdivision (b)(3), (to, or knowingly assist another in, concealing or failing to disclose an event that affects a person’s right to insurance benefits), 33 counts, felonies involving moral turpitude per se.
Convictions like these are ultimately great for injured workers and employers because they help to maintain integrity in the workers’ compensation system.
This Bulletin was written by Steve Rosendin, Associate Partner in our San Francisco office. A copy of this Bulletin and the most current twelve months is available on our website at: www.mulfil.com/bulletins