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Medical providers suspended for fraud

Posted On: Aug. 16, 2017 1:01 PM CST

Medical providers suspended for fraud

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: 

  • Leovigildo Sayat, a physical therapist in Lompoc, California, who in October 2015 pleaded guilty in U.S. District Court for the Central District of California as a co-conspirator in a $15 million scheme to defraud Medicare by billing for physical therapy services never provided.
  • Alexander Kiev Martinez, a durable medical equipment provider in El Centro, California, who in April 2016 pleaded guilty in San Diego Superior Court for referring patients in a bribery scheme involving $25 million in improper claims for medical services and devices billed to California workers comp insurance companies.
  • Robert Gogatz, a chiropractor in Murrieta, California, who last May pleaded guilty in Riverside Superior Court to 16 counts of insurance fraud.
  • Robert Alva Rose, a physician in Irvine, California, who pleaded guilty in Orange County Superior Court on Sept. 15, 2015 to two misdemeanors related to his qualifications as a medical provider.
  • Paul Barkal, a physician in San Diego who surrendered his license to the Medical Board of California on Oct. 17, 2005.