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California’s crackdown on workers compensation medical providers found guilty of fraud and other offenses continues with the suspension of five providers this week, bringing the total to 32 this year, the state’s Division of Workers’ Compensation announced Tuesday.
The suspension are in line with state law that requires the department’s administrative director to suspend any medical provider, physician or practitioner from participating in the workers comp system if they are found guilty of fraud or abuse, the division stated in a press release.
Specifically, Assembly Bill 1244 — passed in 2016 — calls for a suspension when one or more of the following is true: the provider has been convicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers comp system, fraud or abuse of a patient, or related types of misconduct; the provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or the provider’s license or certificate to provide health care has been surrendered or revoked under other conditions.
Per the department’s announcement, the following providers were suspended:
Stakeholders called for more tweaks to California’s proposed workers compensation drug formulary, which is slated to go into effect in January 2018 and still needs refining of provisions for weaning injured workers off drugs that would be exempt from prescribing under the new rules, according to several commentators.