Eight Orange County chiropractors, three office administrators and an attorney have been charged by the district attorney’s office after an undercover operation caught them in various schemes used to defraud insurance companies. Apparently this team did it through illegal patient referrals, kickbacks and overbilling for procedures that were never done. Our source for this blog was this news report in the Los Angeles Times.
What the county prosecutor’s office did was set up a fake law office and pose as law office administrators seeking referrals and patients claiming to be suffering from auto accident injuries. Of course, it is illegal for doctors, attorneys and chiropractors to file claims to exchange money for patient referrals. Over the last year or so, investigators sent 250 letters to medical professionals already suspected of fraud. These letters proposed an illegal fee-splitting scheme in which providers would pay up to 30 percent of a patient’s billing in exchange for the referral.
For example, here is how the attorney who has been charged did it. He is accused of coaching an undercover investigator posing as a patient to lie to an insurance company to exaggerate the extent of his injuries and the number of medical visits. The attorney later split the insurance payment between himself, a chiropractor and the investigator posing as a patient.
It is appalling that professionals – especially medical professionals who took an oath to serve the sick and indisposed – would engage in such fraudulent activity. But as auto accident attorneys we know that such unlawful practices are an unfortunate reality. In fact, I wrote about this in my book “The Seven Fatal Mistakes That Can Wreck Your California Personal Injury Claim.” One of the reasons unsuspecting patients get steered into medical liens (a fatal mistake), is because of an unscrupulous attorney or doctor who have one of these tacit partnerships, which are not in the patients’ best interests.
In such instances, the attorney may turn a blind eye to inflated medical bills that have been submitted by a physician or a medical group that he recommends. In turn, the doctor or group will refer patients to the lawyer. As a result of such an arrangement, the patient may finally have to enter a medical lien because it is the only way to secure medical services. That’s because you cannot secure treatment if there is no guarantee of payment. In my opinion, the best option to pay for medical expenses after an auto accident is your own medical insurance. Your second option after medical insurance is to charge your expenses to the medical payments provision of your auto insurance policy. Other payment options include Medicaid, Medicare, Medi-Cal and other government-sponsored programs.