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AB1244 Signed Into Law – Medical Fraud Liens Now Even Weaker

Happy Friday, dear readers!

Your humble blogger brings you a tiny bit of news from Sacramento.  AB1244 has been signed into law and will take effect on January 1, 2017.

The bill, signed into law by Governor Brown on September 30, 2016, holds that “[t]he administrative director shall promptly suspend … any physician, practitioner, or provider from participating in the workers’ compensation system as a physician, practitioner, or provider if the individual or entity meets any of the following criteria…” which primarily focus on felony or misdemeanor convictions having to do with fraud or abuse of Medi-Cal, Medicare, workers’ comp, or a patient.

Other reasons for suspension include financial crimes, or fraud related to qualifications, functions, or duties of a provider of services.

Basically, when there is a plea or conviction for medical-treatment related fraud, all of  the fraudster’s liens will be consolidated for a special hearing, across all WCAB venues, and be heard at one hearing at a particular venue, where there will be a presumption that all the liens are based on fraud.

So, what are we going to do on the defense side?

When you get a lien, and especially when you get a notice of hearing on a lien, do some research on the lien claimant to determine if there was a conviction for fraud.  Usually these things make the news.  After that, it just becomes an issue of informing the administrative director.  In many cases, the AD will probably be on this already.

Previously, the conviction for fraud would have already dealt a blow to any lien claimant’s credibility.  And, given the defenses already available, would make it even harder for lien claimants to recover.  However, now, it looks like the State of California may absorb some of the administrative costs (in the sense that the money employers already pay to fund the DIR will now be used to help them fight off liens) in getting rid of some lien claimants.

It’s a good thing, dear readers.  Happy Friday!

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