California Medical Provider Suspensions Up to 52

The most recent suspensions involve a provider who had pleaded guilty to health care fraud and illegal kickbacks, one whose medical license was suspended in New Mexico after he was charged with sexual assault of a patient, and one who pleaded no contest to grand theft from the California Health Care Deposit Fund, according to the Department of Industrial Relations announcement.

The administrative director of the California Department of Industrial Relations' Division of Workers' Compensation has suspended 52 medical providers this year as of Oct. 26, when three more were added to the total, DIR announced. Administrative Director George Parisotto issued suspension orders against the three; one had pleaded guilty to health care fraud and illegal kickbacks, another's medical license was suspended in New Mexico after he was charged with sexual assault of a patient, and the third pleaded no contest to grand theft from the California Health Care Deposit Fund, according to the announcement.

A law that took effect Jan. 1, 2017, requires the division's administrative director to suspend any medical provider, physician, or practitioner from participating in the workers' comp system if:

  • that person has bee 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, and 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.

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