Workers’ compensation fraud remains a serious area of concern in California. State regulators have committed to taking aggressive measures to hold perpetrators accountable. As reported by Business Insurance, a doctor from Southern California was recently sentenced to ten years in prison for his role in a workers’ compensation fraud scheme. Here, our California workers’ compensation defense lawyers highlight what we know about this case and explain the extreme costs that fraud imposes on our state’s workers’ compensation system.

Background: Los Angeles County Doctor Pleaded Guilty to Workers’ Compensation Fraud

In August of 2022, Randy Rosen, a surgeon from Beverly Hills, California, pleaded guilty to several felony charges as part of a complex workers’ compensation fraud case. Prosecutors contend that Dr. Rosen fraudulently billed insurance companies for unnecessary procedures. He also allegedly had patients undergo unnecessary lab tests at a facility that was owned and operated by his significant other. Once again, insurance companies were billed for the cost of these services. Notably, Dr. Rosen was one of nearly 200 providers suspended by the California workers’ compensation system in 2022. 

Workers’ Compensation Fraud Sentence: 10 Years in Prison, Serious Financial Penalties

Workers’ compensation fraud is a very serious criminal offense in California. The penalties that Dr. Randy Rosen will face in relation to his guilty plea are significant. Dr. Rosen has been sentenced to 10 years in prison. In addition, he will also face more than $30 million in financial sanctions. More specifically, Dr. Rosen has been ordered to pay more than $9 million in restitution. He will also forgo the ability to recover approximately $22 million in outstanding workers’ compensation medical liens. 

Workers’ Compensation Fraud is an Enormous Problem in Our State

Workers’ compensation fraud is a serious problem in California, with estimates suggesting that it costs the state between $1 to $3 billion per year. Workers’ compensation fraud is a type of fraud that happens when an employee files a false or exaggerated claim for workers’ compensation benefits, when a medical professional engages in improper billing practices, or when an employer fails to properly report payroll and accidents to avoid paying premiums or benefits.

The cost of workers’ compensation fraud is borne by the entire system. Indeed, it is the parties that are playing by the rules—from employers and employees to insurers and claims administration firms—that end up bearing the cost of workers’ compensation fraud.

Consult With Our California Workers’ Compensation Defense Attorney Today

At Yrulegui & Roberts, our California workers’ compensation defense lawyers have the proven expertise you can trust in a complex case. If you are dealing with any type of workers’ compensation fraud matter, we are here to help. Contact us now to set up a fully confidential consultation. Our law firm works in WCAB locations throughout the whole area, including Fresno, Bakersfield, Sacramento, Stockton, Redding, San Jose, Salinas, Santa Barbara, Oxnard, and Van Nuys.