California Workers’ Comp Division Suspends 6 Medical Providers for Fraud

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The California Division of Workers’ Compensation has suspended six more medical providers from participating in the state’s workers’ comp system, bringing the total number of suspended providers to 38.

The suspensions were made possible by the passage last year of Assembly Bill 1244, which requires the DWC administrative director to suspend any medical provider convicted of a crime involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ comp system, a patient, or related types of misconduct.

DWC Acting Administrative Director George Parisotto issued orders of suspension against the following providers:

Jeffrey Campau and Landen Mirallegro of Yorba Linda, co-founders of the medical equipment company Aspen Medical Resources, MRI diagnostic facility Elite Mgmt. LLC dba Elite Diagnostics, and an MRI services company, Regional Medical Services LLC. Campau and Mirallegro pled guilty in Orange County Superior Court on May 5 to medical insurance fraud for their involvement in an overbilling scheme in which they defrauded insurance companies of more than $70 million. Along with their co-defendant, Campau and Mirallegro agreed to pay over $8 million in restitution to several insurers and self-insured employers, and to voluntarily dismiss liens of nearly $140 million, in the case involving Aspen Medical Resources.
Simon Hong of Brea, a medical clinic operator who on Oct. 19, 2016 was found guilty by a federal jury in Orange County of 19 counts of health care fraud, illegal kickbacks, and identity theft involving the Medicare program.
Chi Hong Yang of San Gabriel, who pled guilty in Kern County Superior Court on Aug. 2, 2013 to conspiracy to commit insurance fraud, involving among other things billing and obtaining payment for services not provided. Yang surrendered his physician’s and surgeon’s certificate earlier this year.
Rafael U. Chavez of Rancho Cucamonga, due to revocation of his certification as a physician assistant by the Physician Assistant Board of California on June 19, 2014.
Wendell Wenneker of Napa, whose physician’s and surgeon’s certificate was revoked on June 2 by the Medical Board of California.

AB 1244 requires the DWC administrative director to suspend any medical provider, physician, or practitioner from participating in the workers’ comp system in cases in which any of the following is true: They were onvicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ compensation system, fraud or abuse of a patient, or related misconduct; they were suspended due to fraud or abuse from the Medicare or Medicaid programs; or the provider’s license to provide health care has been surrendered or revoked.