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Hospital owner's role in workers' comp fraud scheme exposed

In a prior post, we highlighted the indictment of California State Senator Ron Calderon based on accusations that he accepted bribe money from a Long Beach hospital owner in exchange for legislative favors. Essentially, Calderon pledged his support for proposals that would hinder or stall changes in state workers’ compensation laws with regard to how health care providers are reimbursed for performing spinal procedures.

The hospital owner, Michael Drobot, was also indicted by federal authorities for his part in the scheme. He is accused of taking millions in kickbacks in exchange for patient referrals to have spinal surgeries at his hospital. He then allegedly would bill the state’s workers’ compensation system for procedures that were reportedly unnecessary or unduly expensive. Ultimately, he is accused of billing nearly $500 million in bogus costs.

According to a recent Sacramento Bee report, Drobot was able to act as the manufacturer of the medical equipment used in the procedures. This basically allowed him to charge workers’ comp insurers nearly ten times the amount of his equipment costs without any pushback.

In addition to the financial pressures put on the workers’ comp system, the scheme also put workers at considerable risk for complications and future pain. It was also reported that some patients lost their lives as a result of unnecessary spinal surgeries.

Nevertheless, the scheme is another example of the fraud that plagues the system. If you suspect that you have received fraudulent workers’ comp claims, a conversation with an experienced attorney can help you decide what course of action to take.  

Source: “Drobot-Calderon workers compensation scandal shows anti-fraud effort can work,” Mark Sektnan, March 30, 2014

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