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Heidi K. Hengel is an associate attorney with our Bay Area office. In adition to workers' compensation defense, Ms. Hengel's experience includes civil litigation in San Jose and criminal defense in San Francisco. She graduated from the University of Wisconsin - Madison in 2005 with a major in Political Science and minor in Women's Studies. She attended Golden Gate University School of Law in San Francisco, graudating with honors in May 2008 and receiving the Outstanding STudent Award for her graduating honors program class. She was also nominated as a Rising STar attorney in Super Lawyer Magazine in 2009. Ms. Hengel is certified to practice before all Federal and State courts in California.

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Workers' Compensation Daily News for May 25, 2016

Glendale Physician Pleads Guilty to Illegal Distribution of Opioids
Wed, 25 May 2016 08:26:47 - Pacific Time
A Glendale doctor has agreed to plead guilty to a federal drug trafficking charge for illegally distributing hydrocodone, a powerful painkiller best known by the brand names Vicodin and Norco.

Dr. Manasseh Nwaigwe, 72, who resides in Glendale and operated a medical office in Boyle Heights, agreed to plead guilty to one count of illegal distribution of hydrocodone. As part of the agreement with the government, Nwaigwe will forfeit to the government more than $97,000 in cash that Nwaigwe admits were proceeds derived from his illegal prescriptions.

In the plea agreement, Nwaigwe admits that, on five occasions in May and July 2015, he wrote prescriptions for drugs to undercover law enforcement officers in exchange for cash.

Nwaigwe prescribed the drugs hydrocodone, clonazepam (commonly known by the brand name Klonopin), and promethazine with codeine (a narcotic cough syrup known on the streets as "purple drank" or "sizzurp") to undercover agents who "did not in fact have a medical need for those prescriptions." In exchange, Nwaigwe received $90 cash for each prescription.

Subsequent to the undercover visits, a medical board expert reviewed The CURES report for Respondent, and chose several patients whose prescribing looked suspicious. The expert reviewed patient records for about 12 random patients, which totaled approximately 225 visits. He noticed that there was a pattern with all of these patients, notwithstanding age or sex. The most glaring thing was that every single patient was prescribed the same medications each time they went to see Respondent. They were prescribed a combination of Norco or Vicodin, plus Klonopin or Valium, and Phenergan with Codeine. For each patient, there were no referrals for imaging, physical therapy, urine drug screens or a check of CURES. Each and every patient had the following diagnoses (without evaluations): Chronic Anemia; Hypertension; COPD; UTI or Cystitis; and fatigue/weakness.

Under the terms plea agreement, Nwagiwe will cooperate with the Medical Board of California by surrendering his medical license, which will effectively resolve a pending action filed by the Medical Board against Nwaigwe earlier this year. On March 8, the Medical Board filed an accusation against Nwaigwe that alleged sexual misconduct, prescribing without an appropriate exam and gross negligence.

Under the plea agreement, Nwaigwe also will surrender his DEA registration, which is the federal license that all physicians must have to prescribe controlled substances.

Nwaigwe is expected to appear in United States District Court in Los Angeles on June 7 for an arraignment, at which point a hearing to enter his guilty plea will be scheduled. The drug distribution charge against Nwagiwe carries a statutory maximum penalty of 20 years in federal prison.

The investigation into Nwaigwe was conducted by the Drug Enforcement Administration, the Medical Board of California, the Los Angeles Police Department, the Los Angeles County Sheriff’s Department, the Torrance Police Department, and the Redondo Beach Police Department. Read More...

DWC Posts Amendments for Home Health Care Fee Regs
Wed, 25 May 2016 08:26:39 - Pacific Time
The Division of Workers’ Compensation (DWC) posted amended draft regulations regarding the implementation of a fee schedule for home health care services. Members of the public are invited to present written comments regarding the proposed modifications to dwcrules@dir.ca.gov until 5 p.m. on Wednesday, June 8.

California Senate Bill 863 requires the Administrative Director to establish a fee schedule for home health care services, which range from skilled nursing and therapy services to unskilled personal care or domestic care (chore) services.

Following the Office of Administrative Law’s publication of DWC’s initial draft of these regulations, a public hearing was held November 30, 2015 for comment. There is a transcript of the comments made that day.

Upon review of the comments received, DWC has amended its regulations to provide better organization and clarity. In addition, DWC has adopted rates drawn from the federal Office of Workers’ Compensation Programs fee schedule for home health care services, which provides rates of provider compensation that are higher than in the previous draft. California Senate Bill 542 grants DWC legislative authority to base the home health care services fee schedule on sources other than the federal Medicare and state In-home Supportive Services programs.

The proposed regulations set forth a payment methodology and fees for skilled care by licensed medical professionals and unskilled personal and chore services for injured workers in the home setting that will provide incentives for an adequate number of potential care providers to participate in home health care for injured workers while containing costs to the overall workers’ compensation system.

The updated notice and text of the regulations can be found on the proposed regulations page.

One of the more interesting changes, Section 9789.91 now provides that in cases where a claims administrator and an injured worker agree that the injured worker may receive care from a provider who does not work for a home health care agency or home care organization, that payment for those services will be made to the injured worker, rather than the provider, so that an employment relationship is not established or presumed between the claims administrator and the provider. Therefore, it will be incumbent upon such providers to have an appropriate employment agreement in place directly with the injured worker. Read More...

Attorney Ron Mix Admits to Illegal Referral Fees for Comp Cases
Tue, 24 May 2016 09:43:49 - Pacific Time
Former San Diego Chargers great Ron Mix, a member of the Pro Football Hall of Fame, pleaded guilty Monday in federal court in Missouri to a tax fraud charge stemming from his post-football career as a California workers compensation lawyer. Mix, 78, faces a potential sentence of three years in prison and $250,000 fine. Mix agreed to pay $49,543 in restitution to the IRS.

Mix has been a successful workers compensation lawyers since his retirement from the game. Many of his clients are former professional athletes who made claims for injuries suffered during their playing days, usually years after their careers ended. Mix filed about 300 such cases in the final month before the law changed in late 2013, according to news reports at the time. But this federal criminal case was prosecuted in Kansas City because some of the clients referred to Mix lived in the Western District of Missouri. None of their names was released.

According to the plea agreement filed in federal court attorney Mix admitted the following, "Between October 18, 2010 and December 16, 2013 in the Western District of Missouri and elsewhere, the defendant, RONALD JACK MIX ("MIX"), doing business as the LAW OFFICES OF RON MIX, entered into an arrangement whereby INDIVIDUAL F, who is not an attorney, would refer professional athletes to MIX and the LAW OFFICES OF RON MIX, so that defendant, MIX, could file workers’ compensation claims in the state of California on behalf of these former professional athletes. MIX then agreed to make donations to a charity as directed by INDIVIDUAL F. The charity was THE SIXTH MAN FOUNDATION d/b/a PROJECT CONTACT AFRICA ("PCA"), a federally-registered tax exempt 501(c)(3) charity. The individuals referred were in need of the services provided by MIX, he was well-qualified to perform these services, and he properly performed the services to the individuals who were referred."

"MIX admits that he wrote checks out of his personal bank account and his law firm’s bank account to the charity as directed by INDIVIDUAL F while the latter made referrals of potential workman’s compensation cases. These donative payments ranged anywhere from $5,000 to $25,000. Mix admits that some of the professional athletes referred to him by INDIVIDUAL F, resided in the Western District of Missouri, so that he could file workers’ compensation claims in the state of California on their behalf, which was a proper venue under California law."

"MIX admits that from 2010 through 2013, he made approximately $155,000 in donations for client referrals."

"MIX also admits that the payments to PCA were listed as "charitable contributions" on his Form 1040s, U.S. Individual Income Tax Returns, for calendar years 2010, 2011, 2012, and 2013." However you cannot make a charitable contribution that is deductible when you get something back in return.

Jean Paul Bradshaw, Mix’s lawyer in Kansas City said Mix was told that the referrals would stop unless he donated more and more money to the charity. Prosecutors said that Mix’s donations ranged between $5,000 and $25,000.

The practice of paying a non-lawyer a fee for a referral is known as "capping," and is illegal in California. Mix’s guilty plea will have to be reported to the State Bar. It is not clear at this time what action the California State Bar may take as a result of this plea agreement.

In exchange for his plea, the government agreed "not to bring any additional charges against defendant for any federal criminal offenses related to conspiracy to defraud the IRS or the United States, wire fraud, mail fraud, or filing a false tax return, or any other charge related to the conduct set forth in Paragraph 3 of this plea agreement for which it has venue and which arose out of the defendant’s conduct described above." Read More...

Former Claims Adjuster Sentenced to 4 Years for Embezzlement
Tue, 24 May 2016 09:43:41 - Pacific Time
Elizabeth Louise Brown, 48, of Canyon Country, a former claims adjuster with Explorer Insurance, pleaded guilty to two counts of insurance fraud with a white collar crime enhancement penalty for crafting an elaborate scheme to defraud her employer, Explorer Insurance out of more than $289,000. Brown was sentenced to four years in state prison and ordered to pay $289,999 in restitution.

According to Department of Insurance detectives, between January 2013 and September 2015, while employed by Explorer Insurance as a claims adjuster, Brown embezzled from the company by adding friends and family members to claims, which resulted in the insurer issuing fraudulent payments to Brown's co-conspirators. In the end, Brown embezzled more than $289,999 from her employers.

Evidence of Brown's alleged crimes were discovered by Explorer Insurance when they identified fraudulent checks issued in 87 claims assigned to her. Explorer terminated Brown's employment and, as required by law, reported the suspected crimes to the department, which launched a criminal investigation. The investigation into how Brown profited from the scheme is ongoing.

A team of California Department of Insurance police officers raided her residence on the 26800 block of Madigan Drive in Santa Clarita in the early morning hours of April 7 as part of the investigation.

"I walked outside and there’s just a troop of (officers)," said a witness who asked to remain anonymous, adding that one officer was carrying a battering ram designed to break down doors.

The witness also recalled seeing a van pull up to the residence not long afterward, where several people from inside the house were escorted by police. "They tucked them in the back and drove off," he said

Fifteen of Brown's co-conspirators were also arrested and to date, seven have entered guilty pleas. Another four suspects remain at large and are being sought by department detectives.

Read More...

Jury Awards Aetna $37.5 Million in Bay Area Surgical Fraud Case
Mon, 23 May 2016 09:45:18 - Pacific Time
A Santa Clara  jury awarded Aetna, Inc. $37.4 million from Bay Area Surgical Management, LLC ("BASM") six of its affiliated surgery centers and its three principals. Aetna had accused the surgery center company of a massive conspiracy to defraud Aetna and other carriers who offer out-of-network benefits by paying off doctors, lying to patients and lying to carriers and employers, the result of which was overpayment by Aetna for surgeries to the extent of tens of millions of dollars. Aetna asserted causes of action for fraud, intentional interference with contractual relations and unjust enrichment. The BASM defendants have announced that they will appeal.

According to the report on Lexology.com, Aetna’s specific complaints in the 2012 lawsuit were several: first, Aetna contended, BASM paid off doctors by selling them ownership interests at a price far below fair market value. Because physicians paid only a nominal price for their ownership interests, BASM was able to pay annual rates of return of several hundred percent. In return, Aetna claimed, the owner physicians shifted their cases to BASM centers, and especially their high-price procedures with good coverage. BASM also reallocated ownership to reward high producing physicians and punish those who were less profitable.

BASM also concealed from patients how much the surgery centers were charging for procedures by not collecting the patients’ co-payment or, Aetna, claimed, telling the patient that the charge was substantially lower than the amount the surgery centers billed to Aetna. Aetna presented testimony that the waiver of coinsurance skews the healthcare system by encouraging patients to get procedures at more costly facilities. Aetna also presented evidence that BASM’s charges were significantly higher than other area facilities, both in and out of network.

Aetna further presented evidence that the BASM surgery centers actively sought patients with good out-of-network benefits. BASM surgical schedulers were instructed not to schedule patients whose plans had a daily max for out-of-network benefits and emails and text messages from BASM principals to owner physicians emphasized the kinds of cases they were to bring in order to maximize profit.

The result of these practices, Aetna argued, was an insidious conspiracy to bilk the insurance company out of multiple millions of dollars.

BASM had argued that it was the insurance company’s responsibility to protect itself. Further, per BASM, everyone in the health care industry knows that billed charges are arbitrary. Only payers can determine what to pay for a particular procedure at a particular facility and "no one ever pays the sticker price."

The jury unanimously sided with Aetna and awarded all of the damages Aetna claimed. Still pending in California state court is a similar case by United Healthcare Services, Inc. set for trial later this year and a case in California federal court by BASM against Aetna, United and some in-network surgery centers alleging an anti-competitive conspiracy to destroy BASM’s business.

The company continues to run six surgical care centers from Burlingame to San Jose to Los Gatos. Court documents show the FBI and the U.S. Attorney's Office in San Jose are making inquiries in the case. The latter has already issued a subpoena seeking information from Aetna. Aetna has filed two similar lawsuits against physician-owned surgery centers in Texas and one in Pennsylvania. Read More...

Union Agreement Does Not Limit 132a Authority
Mon, 23 May 2016 09:45:12 - Pacific Time
Alfonso Salazar worked as a floater relief worker for Leprino Foods, when,he sustained serious injury in 2011 to his right hand and arm. The claim was accepted and medical treatment and benefits were provided.

A few weeks after his injury he was given an "Employer Warning Record" advising that he had failed to "tag out-lock out" the machine on which he was injured. As such, Applicant was terminated. A Petition for Increased Benefits pursuant to Labor Code § 132a was filed. Meanwhile, the underlying matter settled by way of Stipulations With Request for Award, approved February 11, 2014.

The Labor Code§ 132a discrimination case proceeded to trial. The WCJ found that Applicant's termination was not based on a "good faith" personnel action. It was ordered that Applicant receive the supplemental benefit of $10,000 and be reinstated to his prior position.

After the 132a award issued, the employer alleged that the Teamster Pension Trust refused to administer the increase and they believed that it would violate the collective bargaining agreement to pay Applicant directly. The orders in the Amended award were quite specific as to how the $10,000.00 was to be paid. The Order stated: "[I]t is hereby ordered that Leprino Foods make payment of the increase directly to Mr. Salazar, Applicant herein. Amount to be adjusted by the parties." There was nothing in the undersigned's Amended Orders, or in the Orders of October 14, 2015 and January 28, 2016 that the sum of$10,000.00 be paid to the Teamster Pension Trust.

The employer petitioned for reconsideration. The WCJ recommended that the petition be denied reasoning that "If payment of the $10,000.00 supplemental benefit places Petitioners into some type of breach of the collective bargaining agreement with the Teamsters, which is not of Applicant's doing. Petitioners triggered the entire chain of events by discharging Applicant from employ without benefit of a "good faith" personnel action. Petitioners had ample time to challenge the November 20, 2014 Amended Findings of Fact, Award, Order, and Opinion on Decision. Petitioners chose not to do so. Petitioners cannot now hide behind a claim of contractual breach with an unrelated third party to avoid a duty they have been court-ordered to comply with for more than one year."

The WCAB denied reconsideration in the panel decision of Salazar v Leprino Foods. An employee who suffers retaliation or discrimination in violation of section 132a is not only entitled to an increase in workers' compensation benefits, but is also ..... entitled to reinstatement and reimbursement for lost wages and work benefits caused by the acts of the employer."

Here, defendant does not dispute that applicant's termination was a violation of Labor Code section 132a, nor that the WCAB has the authority to issue both penalties and lost work benefits in the form of an increased pension benefit for the time applicant lost between his wrongful termination and his permanent and stationary date. Instead, defendant contends that to comply with the WCJ's Order to issue the increased pension benefit directly to applicant would necessarily mean violating the collective bargaining agreement. However, the WCJ has not ordered defendant to pay increased pension benefits to applicant. Defendant was ordered to' pay applicant damages to be calculated/adjusted by reference to his lost pension benefit. Accordingly, the WCJ had proper authority to order defendant pay applicant damages to be calculated by reference to his lost pension benefit. Read More...

Are Injured Workers Lying About Not Using Illicit Drugs?
Fri, 20 May 2016 10:45:35 - Pacific Time
It is critical that claims administrators and treating physicians obtain an accurate history of illegal substance use and abuse from an injured workers. This history is important when there is a physical injury for purposes of appropriately prescribing an opioid pain medication. This history is important when there is a psychiatric injury in order to determine causation and apportionment.

With regard to physical injuries, the DWC is currently in the process of developing the Medical Treatment Utilization Schedule with a new 137 page Opioid Treatment Guideline. Section 3.3.1.1 "Screening for Drug Misuse/ Abuse" mandates that physicians "use validated screening tools for predicting the risk of drug misuse ... before beginning chronic opioid treatment." These screening tools document the claimant's "personal history of substance abuse" in order to determine risk of abuse of pain medication. This new proposed DWC guideline makes the importance of obtaining a drug history from a claimant not only quite clear but also a mandatory requirement.

Yet it is rare to see a claimant actually admit to illicit drug use in a workers' compensation claim. What are the odds that illicit drug use is as rare as these common California workers' compensation histories suggest?

The New York Times reports that all over the country, employers say they are struggling to find workers who can pass a pre-employment drug test. That hurdle partly stems from the growing ubiquity of drug testing, at corporations with big human resources departments, in industries like trucking where testing is mandated by federal law for safety reasons, and increasingly at smaller companies.

But data suggest employers’ difficulties also reflect an increase in the use of drugs, especially marijuana - employers’ main gripe - and also heroin and other opioid drugs much in the news.

Drug use in the work force "is not a new problem. Back in the ’80s, it was pretty bad, and we brought it down," said Calvina L. Fay, executive director of the Drug Free America Foundation. But, she added, "we’ve seen it edging back up some," and increasingly, both employers and industry associations "have expressed exasperation."

Data on the scope of the problem is sketchy because figures on job applicants who test positive for drugs miss the many people who simply skip tests they cannot pass. Nonetheless, in its most recent report, Quest Diagnostics, which has compiled employer-testing data since 1988, documented an increase for a second consecutive year in the percentage of American workers who tested positive for illicit drugs - to 4.7 percent in 2014 from 4.3 percent in 2013. And 2013 was the first year in a decade to show an increase.

In Colorado, "to find a roofer or a painter that can pass a drug test is unheard-of," said Jesse Russow, owner of Avalanche Roofing & Exteriors, in Colorado Springs. That was true even before Colorado, like a few other states, legalized recreational use of marijuana. In a sector where employers like himself tend to rely on Latino workers, Mr. Russow tried to diversify three years ago by recruiting white workers, vetting about 80 people. But, he said, "As soon as I say ‘criminal background check,’ ‘drug test,’ they’re out the door."

A much broader data trove, the federal government’s annual National Survey on Drug Use and Health, reported in September that one in 10 Americans ages 12 and older reported in 2014 that they had used illicit drugs within the last month - the largest share since 2001

If this data is correct, a random sample of 100 open workers' compensation claims in a typical inventory should have 10 cases with an admission of use of illicit drugs within the prior month. Should any inventory of claims show a lower percentage, or worse yet, not a single case of an admission of illegal drug use, the odds are high that several of the claimants are lying. Then the question of course is "which ones?" Read More...

4th DCA Sustains School District Employee's Fraud Conviction
Fri, 20 May 2016 10:45:23 - Pacific Time
In November 2009, Chany Lopez was an employee of the San Diego Unified School District. While driving a district truck, he was sideswiped. Although he complained to coworkers that he was injured in the accident, he then declined any medical treatment .

Later, Lopez submitted a workers' compensation claim for pain in his neck and lower back arising from the accident. Third party administrator York Risk Services opened a file and provided benefits. He denied having "previous occupational injuries or illnesses" and "any preexisting conditions that complicate or prolong diagnosis or treatment" when evaluated by his treating physician and to an investigator when interviewed for an AOE-COE investigation. He also denied knowing anything about the workers' compensation system and denied he had been through the process of filing a claim before the November 2009 accident to the investigator.

York discovered that Lopez had in fact submitted workers' compensation claims when employed by the City of San Diego in 1991 for left shoulder, left arm and upper back and in March 1993 for low back and both legs; and also in January 1996 for low back.

A jury convicted Lopez of four felony counts of unlawfully making a knowingly false and fraudulent statement in violation of Insurance Code section 1871.4, subdivision (a)(1) in connection with his filing of a workers' compensation claim. The court sentenced him to three years' formal probation, including 180 days in custody in a work furlough program.

On appeal, Lopez contended the court erred in instructing the jury, in denying his motion for acquittal under Penal Code section 1118.1, and in refusing to reduce his felony convictions to misdemeanors. He further contends the evidence is insufficient to support his convictions. The Court of Appeal in the unpublished case of People v Chaney Lopez rejected his arguments and sustained the conviction.

With regard to the jury instruction, Lopez argued that Insurance Code section 1871.4, subdivision (a)(1) requires the People to show that defendant, as opposed to the insurer, knew his alleged misstatements were material. This section provides in relevant part that it is unlawful to "[m]ake or cause to be made a knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying any compensation, as defined in Section 3207 of the Labor Code."

The Court of Appeal ruled that "the jury was properly instructed that the false or fraudulent statement must be material - viewed from the perspective of an insurer - and that, when defendant made the statement, he had the specific intent to obtain workers' compensation benefits."

Lopez also contended that he should only be found guilty of one felony count for making false or fraudulent statements in connection with his 2011 workers' compensation claim because, even assuming his omissions were material, there allegedly was only one victim - the district - and there was only one claim for workers' compensation benefits.

The Court of Appeal rejected this argument and ruled that "defendant on four separate occasions made knowingly false statements to four separate individuals in connection with his 2011 workers' compensation claim. As we have found, under the plain language of Insurance Code section 1871.4, subdivision (a)(1), each false statement constituted a separate offense." Read More...

Salinas Pain Physician Arrested on 37 Felony Charges
Thu, 19 May 2016 07:44:30 - Pacific Time
Salinas pain physician Steven Mangar was arrested in his Romie Lane office known as Pacific Pain Care, on 37 felony charges of fraud and writing illegal prescriptions. Mangar was booked in Monterey County Jail, where he's currently being held on $1 million bail. The charges include submitting fraudulent health insurance claims and billings, furnishing drugs to an addict, unlawful prescription of medicine to patients who didn’t have the condition for which it was intended, and enhancements alleging Mangar’s conduct resulted in him fraudulently taking more than $500,000. The unlawful prescribing charges involve prescriptions Mangar wrote at Pacific Pain Care and include oxycodone, hydrocodone, morphine, Dilaudid, and other highly addictive and dangerous medications.

The DA's complaint identifies 25 victims of these alleged crimes, identified as John Doe and Jane Doe to protect their privacy. The Californian reports that he was the third leading prescriber of hydrocodone, or Vicodin, in the state. If convicted, he faces a maximum sentence of 44 years and eight months in prison.

The California Medical Board, which has the power to revoke physicians' licenses, has been notified of Mangar's arrest and the charges against him. The medical board has been examining Mangar for years, and the DA's office and California Department of Insurance later joined in the investigation.

The medical board issued its first disciplinary order against Mangar in 2012, when he was placed on probation. As part of a settlement agreement, he acknowledged he had failed to keep adequate records.  In 2013 he was cited for violation of probation, and then an amended complaint followed on Jan. 7 of this year based on complaints numerous patients lodged against him.

On Valentines day In February 2014, Mangar was arrested on suspicion of driving under the influence of methamphetamine after a California Highway Patrol officer stopped him near Highway 101 and Sanborn Road. Due to a Department of Justice crime lab backup, he was not arraigned on that charge until nearly a year after his arrest. The case for that misdemeanor charge is set for trial in June.

After the DUI charges were filed, in February 2015, agents with the Monterey County District Attorney’s Office’s Health Care and Workers’ Compensation fraud units served search warrants on his West Alisal Street office and his home on Madeira Avenue in Salinas with help from the State Medical Board, the Department of Insurance, the Drug Enforcement Agency and the DOJ Office of the Inspector General.

"Multi-faceted insurance fraud schemes are exceedingly sophisticated," District Attorney Dean Flippo wrote in a press statement. "This complex investigation required review of tens of thousands of pieces of evidence. The review was painstaking and took approximately two years to complete. The investigators on this case have worked countless hours conducting numerous interviews of affected patients and witnesses, and maintained diligent investigative efforts, which resulted in the meticulous collection of evidence." Read More...

Fresno County Worker Peads Not Guilty to 11 Fraud Counts
Thu, 19 May 2016 07:44:22 - Pacific Time
Christina Hernandez, a former Fresno County worker in the Department of Behavioral Health, pleaded not guilty Tuesday to an 11-count indictment charging her with health care fraud and embezzlement from a health-care benefits program, Acting U.S. Attorney Phillip A. Talbert announced.

According to court documents, Hernandez, 39, now a resident of Las Vegas, was a provider relations specialist at the Fresno County Department of Behavioral Health, which is responsible for administering mental health services to Fresno County’s Medi-Cal beneficiaries. Hernandez was responsible for reviewing and approving claim forms from private mental health care providers who provided services to Medi-Cal beneficiaries.

The indictment alleges that Hernandez submitted claim forms for medical services that were never provided and that she subsequently cashed the reimbursement checks for her own benefit. The indictment also alleges that Hernandez stole reimbursement checks that the county issued to doctors for actual medical services provided. In total, it is alleged that Hernandez stole approximately $98,560 from the county department.

If convicted, Hernandez faces a maximum of 10 years in prison and a $250,000 fine. Read More...

Past Week News Archive


CalChamber of Commerce Identifies 19 Pending "Job Killer" Bills: Wed, 18 May 2016 08:35:09 - Pacific Time: Read More...


Walgreens to Provide Opioid Antidote for Free in 35 States: Wed, 18 May 2016 08:35:04 - Pacific Time: Read More...


Disabled Worker With Shoulder Injury Caught Bench Pressing 315 Pounds: Tue, 17 May 2016 08:24:07 - Pacific Time: Read More...


Officials from Irvine Based Company Face $1.5 Million Fraud Charges: Tue, 17 May 2016 08:24:01 - Pacific Time: Read More...


Attorney Jason Hilfrink Returns to Floyd, Skeren & Kelly, LLP: Mon, 16 May 2016 09:54:39 - Pacific Time: Read More...


DWC Appoints Ellen Langille to Ethics Advisory Committee: Mon, 16 May 2016 09:54:33 - Pacific Time: Read More...


9th Circuit Defines MMI Status in Longshore Case: Fri, 13 May 2016 09:42:38 - Pacific Time: Read More...


DWC Announces New IMR Search Tool: Fri, 13 May 2016 09:42:32 - Pacific Time: Read More...


Proposed Law - Help For Children Born Dependent on Opioids: Thu, 12 May 2016 06:46:49 - Pacific Time: Read More...


Fentanyl - The Deadly New Heroin: Thu, 12 May 2016 06:46:41 - Pacific Time: Read More...