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Fraud has long been a concern for the workers compensation sector but 2022 saw the industry and law enforcement in California fight back against the problem.
One medical provider who felt the sharp end of the anti-fraud efforts was a surgeon in Beverly Hills, California, who received 10 years behind bars for comp fraud.
Dr. Randy Rosen pleaded guilty in August to numerous felony counts in connection with what prosecutors said was a “massive scheme and conspiracy” to fraudulently bill insurers for unnecessary procedures performed on drug-addicted patients.
Dr. Rosen was also charged with having patients undergo unnecessary drug tests that were analyzed by a lab owned by his girlfriend, Liza Visamanos, who ended up pleading guilty to two felony insurance fraud counts and was given one year of home confinement.
In addition to the 10-year prison sentence, the courts also ordered Dr. Rosen to pay $9.1 million in restitution and to not pursue payment on more than $22.35 million in outstanding workers compensation liens. The story about his sentencing was the fourth most read workers comp-related story on Business Insurance’s website in 2022.
In November, the California Department of Industrial Relations Division of Workers’ Compensation suspended Dr. Rosen from participation in the state workers compensation system because he is a convicted felon.
The suspension was scheduled to begin in late December unless Dr. Rosen requested a hearing.
Dr. Rosen was one of 178 medical providers suspended by the Division of Workers’ Compensation in 2022 as of late September.