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Sylvia Pulido is a Hearing Representative in our Camarillo office. Sylvia expands on a quarter-century experience in the workers' compensation industry by now joining the defense litigation ranks. She began in 1989 representing applicants and managing the office. She subsequently worked as a Senior Claim Examiner before joining our firm. Sylvia is a Certified Paralegal who is also experienced in Social Security Administration proceedings, Unemployment Insurance Appeal hearings, Personal Injury claims, and the Long Shore and Harbor Act. Adding to her credentials, she is versed in defending uninsured employers, is experienced with the Education Code benefits system, and is adept at handling Medicare-Set-Aside and excess retention issues. Sylvia is certified by the Department of Industrial Relations, Self-Insurance Plans as a Workers' Compensation Administrator. Similarly, she has completed both the Workers' Compensation Claims Administration (WCCA) and Workers' Compensation Claims Professional (WCCP) Certifications by the Insurance Education Association. As a value-added benefit, she is bilingual and a Certified Notary. In her personal life, Sylvia is a Lector, a mentor, and a youth instructor at her local church.

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Workers' Compensation Daily News for Jul 29, 2016

CMS Provider "Integrity Efforts" Reduces "Pay-and-Chase" Losses
Thu, 28 Jul 2016 09:32:03 - Pacific Time
CMS released a report this week showing that investments made in program integrity activities pay off. From October 1, 2012 through September 30, 2014 every dollar invested in CMS’ Medicare program integrity efforts saved $12.40 for the Medicare program. Total savings from program integrity efforts were nearly $42 billion over the two-year period covered by the report.

CMS has achieved this impact by using a multifaceted approach, ranging from provider enrollment and screening standards, to use of enforcement authorities, to use of advanced analytics such as predictive modeling. It has previously reported on various outcomes tied to specific programs.

The Department of Health and Human Services (HHS) and its Centers for Medicare & Medicaid Services (CMS) are in the third year of implementing sophisticated predictive analytics technology to prevent and detect fraud. It is using the anti-fraud authorities provided in the Affordable Care Act and the Small Business Jobs Act (SBJA) of 2010,

The Fraud Prevention System (FPS) was created in 2010 by the Small Business Jobs Act, and CMS has extensively used its tools. The SBJA requires that the HHS Office of the Inspector General (OIG) certify the savings and costs of the FPS. CMS achieved certification in the second and third year of the program. For the first time in the history of federal health care programs, the OIG certified a methodology to calculate cost avoidance due to removing a provider from the program. This is a critical achievement as moving towards prevention requires a clear measurement of the future costs avoided.

Since CMS implemented the technology in June 2011, the FPS has identified or prevented $820 million in inappropriate payments by identification of new leads or contribution to existing investigations. During the third year the FPS identified or prevented $454 million in inappropriate payments through actions taken due to the FPS or through investigations expedited, augmented, or corroborated by the FPS. Total savings were 80% higher than the savings from the previous implementation year, with a nearly 10:1 return on investment.

Thus CMS’s efforts to pro actively prevent potentially fraudulent and improper payments from being made have been increasingly effective, moving its efforts away from the "pay-and-chase" method of recovering payments after they had already been made.

The primary focus of the FPS during the first two implementation years was identifying providers with the most egregious behavior for investigation by the new Zone Program Integrity Contractors (ZPICs) created to perform program integrity functions. During the third implementation year, CMS tested new and innovative ways to leverage the FPS technology and best practices to support additional fraud, waste, and abuse activities. In future years, CMS will continue to expand the FPS and the transfer of knowledge related to predictive analytics technology. For example, CMS will expand FPS edits to deny or reject more improper payments and CMS will provide technical assistance to states that decide to implement predictive analytics technology.

CMS collaborates with various partners. Assistance from its contractors, state Medicaid agencies, and law enforcement partners are also instrumental in this effort when potentially fraudulent and improper payments result from intentionally fraudulent activities. CMS welcomes input from beneficiaries, providers, suppliers, and others to inform possible future enhancements to our program integrity strategy. Please contact CMS at 1-800-MEDICARE (1-800-633-4227) or TTY: 877-486-2048 with your thoughts or to report potentially improper billing. Read More...

Red Bluff City Councilman Faces Comp Fraud Charges
Thu, 28 Jul 2016 09:31:57 - Pacific Time
A member of the Red Bluff City Council wanted on fraud charges was arrested Sunday at a Florida airport as he was attempting to flee the country.

The Record Searchlight reports that Suren J. Patel, 43, was heading to somewhere in the Caribbean when he was arrested on an outstanding warrant out of Tehama County Superior Court in California.

The district attorney's office had an investigation into Patel's activities for nearly a year, and charges against him last month.

Patel, owner of the America's Best Value Inn in Red Bluff, faces several charges, including workers' compensation fraud, perjury and conspiracy to commit welfare fraud. Patel also faces charges for not paying taxes to the city. Officials claim Patel did not pay taxes he owed to the city as owner of the Inn.

Patel is also being investigated for embezzlement in connection to a complaint filed by a guest at the hotel who said her credit card was charged $6,000 after she stayed there.

Authorities opened the investigation against Patel in March 2015 and in May of that year the District Attorney's Office took computers, cell phones and business records from the hotel. During the investigation, the DA's Office learned Patel had not paid workers' compensation insurance and was committing welfare fraud by getting two employees benefits.

Red Bluff City Manager Rick Crabtree said Patel told officials he was no longer the owner of the hotel, but that was not confirmed by the DA's Office. "It's a sad circumstance to be in," Crabtree said. "Allegations that a council member has been literally stealing money from the city. It is obviously not a circumstance we're happy about. It's disappointing."

Crabtree said as a result of this case the city has changed how it will collect taxes from hotel owners and conduct more audits.

After charges were filed in June a warrant for his arrest was issued. Officers went to Sacramento to arrest Patel, but he could not be found. Officials were alerted to Patel's whereabouts when he attempted to catch a plane in Florida to leave the country.

The Brevard County Sheriff's Office in Florida listed Patel as an inmate in the jail Sunday, along with his mug shot. The sheriff's office, in Titusville, Florida, only listed his charge as "out-of-state fugitive."

Patel is now in jail in Brevard County, Florida, held on $250,000 bail while he awaits extradition to California.. Read More...

Half of Major Surgery Now Done With Robotic Techniques
Wed, 27 Jul 2016 12:04:37 - Pacific Time
Around half of all major surgery in some countries is now done with robots. The US, UK, and India are among the leading proponents, but many other countries, too, are reporting statistics that would indicate that a significant proportion of surgical procedures is now robotics-assisted.

Harvard Medical School conducted a study in the US of around 500,000 cancer patients between the years of 2003 and 2010, and found that the number of surgical procedures that were robotic-assisted went from 0.7 per cent to 50 per cent over those years.

It also found that the use of robot-assisted surgery was more common among surgeons at teaching hospitals and at intermediate and large-sized hospitals, as well as at urban hospitals.

The Harvard team calculated that robot-assisted surgery increased the overall cost to the hospital, contributing to a 40 per cent increases in annual expenditures.

Dr Steven Chang, who led the study, said: "Our findings give insights on the adoption of not just robotic technology but future surgical innovations in terms of the general pattern of early diffusion, the potential impact on costs of new and competing treatments, and the alternations in practices patterns such as centralization of care to higher volume providers."

In the UK, parts of the National Health Service (NHS) have been introducing robots into surgery over the past few years. In a study by NHS England found that robotics were used to assist surgeons in 49 to 50 per cent of the time in some types of cancer cases, such as prostate cancer. The report said it found no difference in the "operative time", or the duration of the operation itself, "but patients having a robot-assisted procedure had shorter length of admissions".

This is a view that is echoed by other medical professionals, such as Dr Vanita Ahuja, of the York Hospital in Pennsylvania, who produced a report partly based on a nationwide database from 2008 to 2011, and found that robotic-assisted cardiac surgery increased by 600 per cent over the four-year period.

"Robotic-assisted cardiac surgery has lower length of stay than non-robotic surgery," Dr Ahuja said, adding: "Results of this study suggest robotic-assisted cardiac surgery may be as safe as non-robotic surgery and offer the surgeon an additional technique for performing cardiac surgery."

In India, too, surgeons are coming to similar conclusions. Dr N. P. Gupta, chairman of Medanta Kidney and Urology Institute, is claimed to have been the the first to use the robot-assisted surgical technology for radical prostatectomy in India. In an interview with The Times of India, Dr Gupta said "patients can go home in two to three days after the surgery", partly because robots made clear and accurate, which allows suturing to suturing to be with minimum amount of damage to surrounding tissues.

Orthopedic surgery robots use the 3D imaging technology and computer navigation techniques to improve ability of surgeons to place implants with precise alignment. Many studies have shown that these techniques are safer and more effective as compared to traditional surgical techniques. David Bortel, MD, an orthopedic surgeon at MidMichigan Medical Center at Midland, says: "In reality, patients are reporting comparable mobility, functionality and quality of life".

Though emerging technology does not guarantee better results, robotics has always been effective in hip and knee replacement surgeries. Improvements in technology and new methods of verification for implant sizing and placement are significant for patients and surgeons. Read More...

DWC Schedules QME Examination for October 29
Wed, 27 Jul 2016 12:04:32 - Pacific Time
The Division of Workers’ Compensation is now accepting applications for the Qualified Medical Evaluator (QME) examination on October 29.

Physicians who wish to take the exam on October 29, 2016, must submit a completed original Application for Appointment as Qualified Medical Evaluator (QME Form 100). If you submitted an application for the April 16, 2016 exam, you are not required to submit another application, but must send all other documentation/fees required and complete the Registration for the QME Competency Examination (QME Form 102).

The application and all required documentation must be reviewed and approved by the DWC before a physician can be registered for the exam (Title 8, California Code of Regulations §§10, 11). The application must be postmarked by September 15, 2016 in order to qualify for this exam. Qualified registrants will receive a confirmation letter along with a Candidate Information Booklet by email/mail.

Please keep a copy for your records. The DWC is not responsible for late or lost applications.

All physicians are required to pay a non-refundable/non-rollover $125.00 fee to sit for any upcoming QME examination (Title 8, California Code of Regulations § 11(f)(2)). Before appointment as a QME, the physician shall complete a 12 hour course in disability evaluation report writing approved by the Administrative Director (Labor Code § 139.2).

The DWC will assess your annual QME fee after you have successfully passed the QME Competency Exam in order to activate your QME status. Please call 1-800-794-6900 or (510) 286-3700 or email QMETest@dir.ca.gov for further assistance. For additional information regarding the qualifications to become a QME, please visit the DWC website. You may also obtain additional application forms on the website.

For more information please contact the Medical Unit at 510-286-3700 or by email at QMETest@dir.ca.gov. Read More...

Marin Physician Gets Three Years in Prison for Illegal Opioids
Tue, 26 Jul 2016 09:32:57 - Pacific Time
Dr. Michael Roger Chiarottino, age 68, of San Rafael, was indicted by a federal Grand Jury on September 14, 2014. He was charged with fifteen counts of distribution of controlled substances in violation of Title 21, United States Code, Section 841(a)(1).

Chiarottino pleaded guilty on March 8, 2016, to one count of distributing oxycodone, a Schedule II controlled substance, outside the usual course of professional practice and without a legitimate medical purpose.

According to his plea agreement, Chiarottino admitted that he prescribed large quantities of controlled substances (including oxycodone, oxymorphone, hydromorphone, methadone, and hydrocodone) to undercover DEA agents posing as patients in exchange for cash. On each occasion, Chiarottino failed to conduct an appropriate medical examination of, or obtain a sufficient patient medical history from, the undercover agent to support a prescription for such a large quantity of narcotics. In total, Dr. Chiarottino prescribed 46.8 grams of oxycodone (numbering 1,530 thirty-milligram pills) and admitted doing so with the intent to act outside the usual course of professional practice and without a legitimate medical purpose.

In his plea agreement, Chiarottino also admitted that he met with patients and wrote prescriptions for controlled substances at North Bay Pain Management Services and therefore maintained a premises for the distribution of controlled substances. Chiarottino also admitted that, as a licensed physician and DEA registrant, he abused a position of trust and used a special skill to intentionally prescribe controlled substances without a legitimate medical purpose.

Chiarottino was sentenced this July to three years in prison for illegally prescribing oxycodone and other controlled substances.

The sentence was handed down by The Honorable Jeffrey S. White, U.S. District Court Judge. Judge White also sentenced the defendant to a five-year period of supervised release. During this period of supervised release, Chiarottino is barred from providing medical treatment or examining any patient in the course of any employment or professional practice. Chiarottino is also forbidden from prescribing medication or controlled substances to any person and may not supervise any medical practitioner in treating any medical patient or prescribing any medication. Finally, as a condition of his supervised release, Chiarottino is required to cooperate with and not contest any administrative action to revoke or suspend his license to practice medicine or prescribe controlled substances by the Medical Board of California and the Drug Enforcement Administration. Chiarottino’s medical license is currently suspended.

The defendant will begin serving the sentence on October 20, 2016.

The prosecution is the result of an investigation by the Drug Enforcement Administration, the Livermore Police Department, the Pleasanton Police Department, and the Medical Board of California. This case is the product of an extensive investigation by the Organized Crime Drug Enforcement Task Force, a focused multi-agency, multi-jurisdictional task force investigating and prosecuting the most significant drug trafficking organizations throughout the United States by leveraging the combined expertise of federal, state and local law enforcement agencies. Read More...

New Law Says Goodbye to ACOEM Guidelines
Tue, 26 Jul 2016 09:32:49 - Pacific Time
In 2004, the Legislature passed SB 899 which was a major reform of the California workers' compensation system. As a part of that reform, SB 899 required the DWC to create an evidence-based set of medical guidelines to ensure that injured workers were receiving consistent, appropriate treatment from physicians. In the intervening period, SB 899 required that physicians use the ACOEM guidelines, which are a set of widely-utilized evidence-based, peer reviewed medical guidelines that continue to be used in California's workers' compensation system and many other state workers' compensation systems.

In 2009, the DWC promulgated the California-specific workers' compensation system medical treatment guidelines known as the Medical Treatment Utilization Schedule or "MTUS." The MTUS utilized many of the chapters that make up ACOEM, but also referenced additional guidelines or developed independent guidance on medical treatment. As such, while ACOEM is still used as a part of the MTUS, it no longer operates as a stand-alone guideline, and the references to it in the Labor Code can be confusing and cause practitioners to fail to refer to the MTUS.

The DWC has suggested to the legislature that the Labor Code be cleaned up to reflect the fact that the references to ACOEM are no longer accurate, and could potentially be confusing. SB 914 signed into law by Governor Brown this month is intended to accomplish this goal.

The California Neurology Society California, the Society of Industrial Medicine and Surgery and the California Society of Physical Medicine and Rehabilitation voiced support for the new law. There was no opposition reported in the legislative record.

SB 914 takes effect next January.

Although the words "American College of Occupational and Environmental Medicine’ s Occupational Medicine Practice Guidelines" or ACOEM Guidelines as they are generically known disappear from Labor Code section 4614.4, much of the actual text of ACOEM Guidelines remains as part of the MTUS which is adopted by DWC regulation. A review of the bulk of the MTUS chapters shows a straightforward citation directly to the equivalent chapter of ACOEM as follows:

Section 9792.23.1 - Neck and Upper Back Complaints (ACOEM Chapter 8)
Section 9792.23.2 - Shoulder Complaints (ACOEM Chapter 9)
Section 9792.23.3 - Elbow Complaints (ACOEM Chapter 10)
Section 9792.23.4 - Forearm, Wrist, and Hand Complaints (ACOEM Chapter 11)
Section 9792.23.5 - Low Back Complaints (ACOEM Chapter 12)
Section 9792.23.6 - Knee Complaints (ACOEM Chapter 13)
Section 9792.23.7 - Ankle and Foot Complaints (ACOEM Chapter 14)
Section 9792.23.8 - Stress Related Conditions (ACOEM Chapter 15)
Section 9792.23.9 - Eye (ACOEM Chapter 16)

Thus, although the ACOEM Guideline will no longer be with us by name, it most assuredly will be by substance. The DWC has however added chapters to the MTUS where ACOEM did not address needed topics. For example, the MTUS has its own chapter on Acupuncture, Chronic Pain, and Post Surgical Treatment. Read More...

Feds Pass Comprehensive Addiction and Recovery Act
Mon, 25 Jul 2016 08:35:44 - Pacific Time
Opioid abuse has come to the forefront as a serious public health issue. In fact, drug overdoses are now the leading cause of death in the United States, ahead of motor vehicle accidents and firearms. A number of federal legislative proposals have recently been introduced to address this crisis.

In near-apocalyptic terms, U.S. Sen. John Cornyn described the rising tide of American opioid abuse at a Senate Judiciary Committee hearing earlier this year. "Opioid prescription drug and heroin addiction is ripping away at the fiber of our homes and our communities in our nation," Texas' senior senator said. "It’s destroying families, increasing crime, making our communities less safe, hurting our economy, and robbing millions of Americans of their future."

The National Law Review reports that while the U.S. House passed several bills on the issue, the U.S. Senate passed its own measure, S.524, the Comprehensive Addiction and Recovery Act of 2016 (CARA Act). In a bipartisan effort, both the House and Senate appointed conferees to hammer out differences. Those appointed to the Conference included 35 House members (made up of 21 Republicans and 14 Democrats) including Representatives from -key Committees including the House Energy and Commerce Committee and the House Ways and Means Committee. The Senate had seven conferees. While addressing opioid abuse is bipartisan in nature, there was disagreement on process and content throughout the legislative process. One area of debate was funding for the bill.

The Act passed in the Senate by 90-2 after Democrats followed their colleagues in the House of Representatives and dropped calls for the legislation to include additional funding. Senate Majority Leader Mitch McConnell, called for Senate Democrats to pass the measure, citing support for the legislation by the National Association of Counties, the National League of Cities, the Fraternal Order of Police and more than 200 other groups.

CARA includes several provisions concerning the need for expansion of prevention and education on the misuse of prescription pain killers and heroin. Law enforcement agencies and first responders are permitted to distribute naloxone for the reversal of overdose. Evidence-based treatment and intervention programs for incarcerated individuals and those across the country will be implemented. There will be safe disposal sites for prescription medications to diminish the opportunity for ill use. The Act creates a medication assisted treatment program for pain management and expands states' drug monitoring programs to eliminate doctor shopping.

Now that CARA has passed and has been signed into law by the President, stakeholders will be watching closely for implementing rules, regulations, changes to incentive-based patient surveys, as well as any grant opportunities.

Further discussion of funding may arise as Congress discusses budgetary options in 2017and beyond.

"This is a historic moment, the first time in decades that Congress has passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery," said Sen. Rob Portman, a chief author of the legislation. "This is also the first time that we’ve treated addiction like the disease that it is, which will help put an end to the stigma that has surrounded addiction for too long." Read More...

Combining Medications Improve Fibromyalgia Outcomes
Mon, 25 Jul 2016 08:35:38 - Pacific Time
Fibromyalgia was initially thought to be a musculoskeletal disorder. Research now suggests it's a disorder of the central nervous system -- the brain and spinal cord. Researchers believe that fibromyalgia amplifies painful sensations by affecting the level and activity of brain chemicals responsible for processing pain signals.

Now researchers claim that combining pregabalin, an anti-seizure drug, with duloxetine, an antidepressant, can safely improve outcomes in fibromyalgia, including not only pain relief, but also physical function and overall quality of life. Until now, these drugs have been proven, individually, to treat fibromyalgia pain.

"Previous evidence supports added benefits with some drug combinations in fibromyalgia," researchers say. "We are very excited to present the first evidence demonstrating superiority of a duloxetine-pregabalin combination over either drug alone."

This trial compares a pregabalin-duloxetine combination to each monotherapy. Using a randomized, double-blind, 4-period crossover design, participants received maximally tolerated doses of placebo, pregabalin, duloxetine, and pregabalin-duloxetine combination-for 6 weeks.

Primary outcome was measured by daily pain (0-10); secondary outcomes included global pain relief, Fibromyalgia Impact Questionnaire, SF-36 survey, Medical Outcomes Study Sleep Scale, Beck Depression Inventory (BDI-II), adverse events, and other measures.

Based upon these measures, the evidence showed that combining pregabalin and duloxetine for fibromyalgia improves multiple clinical outcomes vs monotherapy.

This study is the latest in a series of clinical trials -- funded by the Canadian Institutes of Health Research (CIHR) -- that Dr. have been conducted on combination therapies for chronic pain conditions. By identifying and studying promising drug combinations, research is showing how physicians can make the best use of current treatments available to patients.

"The value of such combination approaches is they typically involve drugs that have been extensively studied and are well known to health-care providers," says Queen's University researcher Dr. Ian Gilron.

This new research was published in the journal Pain. Read More...

Feds Say "No" to Major Healthcare Mergers
Fri, 22 Jul 2016 08:59:06 - Pacific Time
The U.S. Department of Justice and attorneys general from multiple states and the District of Columbia filed litigation to block Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana, alleging that the transactions would increase concentration and harm competition across the country, reducing from five to three the number of large, national health insurers in the nation.

The department and state attorneys general filed these two merger challenges in the U.S. District Court for the District of Columbia; The complaints allege that the two mergers - valued at $54 billion and $37 billion - would harm seniors, working families and individuals, employers and doctors and other healthcare providers by limiting price competition, reducing benefits, decreasing incentives to provide innovative wellness programs and lowering the quality of care.

Eleven states - California, Colorado, Connecticut, Georgia, Iowa, Maine, Maryland, New Hampshire, New York, Tennessee and Virginia - and the District of Columbia joined the department’s challenge of Anthem’s $54 billion acquisition of Cigna; Eight states - Delaware, Florida, Georgia, Iowa, Illinois, Ohio, Pennsylvania and Virginia - and the District of Columbia joined the department’s challenge of Aetna’s $37 billion acquisition of Humana.

The suit against Anthem and Cigna alleges that their merger would substantially reduce competition for millions of consumers who receive commercial health insurance coverage from national employers throughout the United States; from large-group employers in at least 35 metropolitan areas, including New York, Los Angeles, San Francisco, Denver and Indianapolis; and from public exchanges created by the Affordable Care Act in St. Louis and Denver. The complaint also alleges that the elimination of Cigna threatens competition among commercial insurers for the purchase of healthcare services from hospitals, physicians and other healthcare providers. The merger would eliminate substantial head-to-head competition in all these markets, and it would remove the independent competitive force of Cigna, which has been a leader in the industry’s transition to value-based care.

The lawsuit against Aetna and Humana alleges that their merger would substantially reduce Medicare Advantage competition in more than 350 counties in 21 states, affecting more than 1.5 million Medicare Advantage customers in those counties. Before seeking to acquire Humana, Aetna had pursued aggressive expansion in Medicare Advantage. Aetna, the nation’s fourth-largest Medicare Advantage insurer by membership, has nearly doubled its Medicare Advantage footprint over the past four years. Humana is the nation’s second-largest Medicare Advantage insurer by membership. The lawsuit also alleges that Aetna’s purchase of Humana would substantially reduce competition to sell commercial health insurance to individuals and families on the public exchanges in 17 counties in Florida, Georgia and Missouri, affecting more than 700,000 people in those counties. The lawsuit alleges that by buying Humana, Aetna would eliminate one of its strongest and most capable competitors in these markets.

Anthem, Inc. is headquartered in Indianapolis, Indiana. It is the nation’s second-largest health insurer and the largest member of the Blue Cross and Blue Shield Association. It holds the Blue Cross license in 14 states and provides health insurance to 39 million people. In 2015, Anthem reported over $79 billion in revenues.

Cigna Corp. is headquartered in Hartford, Connecticut. It is the nation’s fourth-largest health insurer. It operates in every state and the District of Columbia and provides health insurance to 15 million people. In 2015, Cigna reported $38 billion in revenues.

Aetna Inc. is headquartered in Hartford, Connecticut. It is the nation’s third-largest health insurer. It operates in every state and the District of Columbia and provides health insurance to 23 million people. In 2015, Aetna reported $60 billion in revenues.

Humana Inc. is headquartered in Louisville, Kentucky. It is the nation’s fifth-largest health insurer, operates in every state and the District of Columbia and provides health insurance to 14 million people. In 2015, Humana reported $54 billion in revenues. Read More...

Santa Barbara Contractor Pleads Guilty in Fraud Case
Fri, 22 Jul 2016 08:58:55 - Pacific Time
The Santa Barbara District Attorney announced that 59 year old Alberto Rodriguez, who lives in Santa Barbara, entered a plea to three felony counts and one misdemeanor count in Santa Barbara Superior Court.

The investigation into Rodriguez and his business, United Seal Coating and Slurry Seal, Inc., began in September of 2013 and was conducted by detectives from the California Department of Insurance along with investigators from the Santa Barbara County District Attorney's Office.

At the time, Rodriguez was performing numerous Public Works contracts for the University of California, Santa Barbara.

One of his workers was injured on the job and filed a workers' compensation claim. Rodriguez denied that the worker was his employee, which was later determined to be false. The investigation into the workers' compensation fraud charges led investigators to other criminal conduct by Rodriguez and his business.

Rodriguez's plead guilty to one felony count of fax fraud for filing a fraudulent tax return under Revenue and Taxation Code section 19705(a)(l); one felony count of Workers' Compensation Insurance Fraud under Insurance Code section 1871.4; one felony count of Supplying False or Fraudulent Payroll Documentation under Unemployment Insurance Code section 2117 .5; and one misdemeanor count of Labor Code section 1779.

Rodriguez will be sentenced on January 18, 2017. It is expected that he will be sentenced to one year in county jail and be ordered to pay restitution to the Employment Development Department in the amount of$65,164.06; The Franchise Tax Board, $24,298; State Compensation Insurance Fund, $77,114.48; and FirstComp Insurance, $2,496.54, for a total of $169,073.08. Read More...

Past Week News Archive


HHS Proposes New Roadmap for Interoperability of Medical Records: Thu, 21 Jul 2016 09:09:59 - Pacific Time: Read More...


Owners of San Jose Chiro Spa Sentenced for Billing Fraud: Thu, 21 Jul 2016 09:09:52 - Pacific Time: Read More...


Bristol-Myers Squibb Settles Kickback Case for $30 Million: Wed, 20 Jul 2016 07:50:07 - Pacific Time: Read More...


53 Big Name Wrestlers File Concussion Class Action: Wed, 20 Jul 2016 07:49:55 - Pacific Time: Read More...


Industry Mourns Death of WorkcompCentral CEO David DePaolo: Tue, 19 Jul 2016 08:23:51 - Pacific Time: Read More...


Applicant Attorney Admits He Was "Greedy and Stupid": Tue, 19 Jul 2016 08:23:42 - Pacific Time: Read More...


WCAB Rules of Practice and Procedure Do Not Apply to UR Process: Mon, 18 Jul 2016 12:46:32 - Pacific Time: Read More...


Study Claims Fewer Painkillers Prescribed in 17 Medical Marijuana States: Mon, 18 Jul 2016 12:46:25 - Pacific Time: Read More...


DWC Reports on SB 863 Progress: Fri, 15 Jul 2016 10:44:00 - Pacific Time: Read More...


WCIRB Summarizes Past and Future Initiatives: Fri, 15 Jul 2016 10:43:53 - Pacific Time: Read More...