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03/20/08 Panels Interpreting 4903.5 in Favor of Lien Claimants, Attorney Says 05/01/08 Applicants Can Pick Their Own Physicians Under 4605, WCAB Rules 05/23/08 Search Warrant Implicates Dozens in Alleged L.A. Fraud Ring 05/27/08 Premier Lawyer Says DA's Wide Net Part of a Smear Tactic 05/30/08 Investigators Arrest Doctor, Serve 22 Warrants in Fraud Probe |
| Search Warrant Implicates Dozens in Alleged L.A. Fraud Ring: 05/23/08
A search warrant unsealed by the Los Angeles Superior Court this month implicates more than 70 people in connection with an alleged fraud ring that purportedly referred unsuspecting claimants to Premier Medical Management Systems in Los Angeles. The September 2007 warrant became public record in early May. It will be added to the record of Premier's pursuit of approximately $70 million in medical liens against several insurers and the California Insurance Guarantee Association. The Department of Insurance's Fraud Unit has been investigating Premier for allegedly operating a medical clinic which allegedly has conspired since 1999 to purchase patients from Walker Advertising. Walker Advertising owns Los Defensores, Legal Rights Defenders, and 1-800-THE-LAW2, according to the search warrant. The warrant alleges that the conspirators directed "unwitting consumers to their business to ensure they receive medical treatment from the Premier facilities. The client believes they are being referred to a legal entity for the purpose of litigating their claim, when in reality they are being persuaded to obtain medical treatment at the Premier facilities." The warrant identifies four attorneys as potential suspects: A. Eli Galam of Murrieta, Robert Iglow and Barry Hinden of Los Angeles, and Mark Polan of Van Nuys. WorkCompCentral left messages with Iglow, Hinden, and Polan, but did not receive return calls as of late Thursday. The warrant contains a flow chart that describes the following scheme: Potential claimants would call 1(800)THE-LAW2, which referred them to Galam's office. The conspirators answered the number for Galam's office, and referred the claimants to a Premier provider for treatment. Premier would pay two companies, Dormie and Double Tap Management, for referral advertising. Dormie and Double Tap Management bought advertising from 1(800)THE-LAW2. In the September warrant, the primary criminal fraud investigator requested the seizure of any documents pertaining to "suspect attorneys" who worked with Premier. The investigator explained, "Since it is believed Premier obtained clients from Walker Advertising and then referred them to attorneys for representation, it is believed these attorneys may also be involved in the criminal conspiracy." The investigation also focused on David Wayne Fish, Birger Greg Bacino, Bradley Dean Groscost, Yolanda Groscost, Mario Polanco, Jeff Bartlett, Rebekah Bartlett and James Drew. Documents list Fish, Bacino, Drew, and Daniel Hurt as owners of Premier. (The warrant states that Hurt is a former owner, who sold his shares to Bacino in 2002 for $5.2 million.) In the litigation between Premier and the insurers, the carriers have previously alleged in court documents that physicians who visited Premier's facilities in the Los Angeles area to treat injured workers typically paid Premier 50%, but sometimes 85% of their treatment fees for the privilege. Premier would develop treatment plans that bore no relationship to recognized guidelines, but instead required extensive diagnostic tests that were always performed by facilities that agreed to pay Premier 50% of fees, the suit alleges. An October 2007 court document from the litigation states: "The provided services are not medically necessary based upon any nationally recognized evidence-based peer-reviewed guideline or protocol. The bills themselves are upcoded. Medical legal reports are created and edited by Premier which affixes physician signature stamps to the reports. Premier lien collectors became permanent fixtures at the various Southern California district offices of the WCAB, clogging the lien calendars at the Los Angeles, Van Nuys, Santa Monica, Riverside, San Bernardino, Pomona, and Long Beach district offices." The insurers also charge that Premier dispensed medicine through pharmacies that agreed to kick back 50% of charges. Premier also provided transportation for patients, interpreting services and durable medical equipment to injured workers through companies that agreed to pay 50% of the fees back to the management company, the insurers say. After Fish claimed that Premier was owed $70 million in unpaid liens, the carriers consolidated the lien cases, with the overall goal of dismissal. Court documents make frequent references to Premier's alleged illegal activity and state, "For three years, Premier repeatedly ignored or refused to comply with defendants' multiple discovery requests, citing to an ongoing criminal investigation by the Los Angeles County District Attorney and asserting Fifth Amendment privilege on the part of Premier and its executives." WorkCompCentral was unable to confirm with the Los Angeles County District Attorneys Office that any arrests or new charges followed the warrant. Officials with the Department of Insurance did not return requests for more information before deadline. Other parties involved in the criminal investigation include the Department of Insurance Fraud Division, the Franchise Tax Board Investigations Bureau, the United States Postal Inspection Service, and the Internal Revenue Service. To read the search warrant, go here: --By John Kamin, Associate Editor
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