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Two principal owners of a medical management company accused of illegally acquiring patients and submitting medical bills totaling more than $60 million in workers’ compensation cases pleaded no contest on Friday, February 19.
David Wayne Fish, 47, and Birger Greg Bacino, 50, were each charged with one felony count of compensation or inducement for referring clients. Premier Medical Management Systems also was charged in the complaint with one count each of submitting a false and fraudulent workers’ compensation claim and filing a false tax return.
“These defendants essentially served as brokers for so-called workers’ compensation professionals, including doctors and attorneys,” District Attorney Steve Cooley said. “In addition to victimizing the workers’ compensation system, these defendants preyed on unsuspecting workers.”
“It is essential that the workers’ compensation system operate on an honest, level playing field on which people with injuries are not improperly referred to individuals who may not have their best interests at heart,” Cooley added. “These types of criminal offenses are to the detriment of honest professionals who are dedicated to serving the workers’ compensation community.
Albert MacKenzie, deputy-in-charge of the Fraud Interdiction Program, said the investigation disclosed that Fish and Bacino engaged in the illegal acquisition of patients from an elaborate scheme through which they purchased several thousand workers’ compensation client referrals from an attorney television advertising service.
When a referral was received for a prospective workers’ compensation case, the client was sent to doctors and other healthcare providers within the defendants’ business network. Premier Medical Management Systems did the billing and collection work in return for a 50 percent, or greater, fee. After meeting with a healthcare provider, the client was sent to a workers’ compensation attorney with whom the defendants also had a business relationship.
Prior to today’s court appearance, Fish paid $750,000 and Bacino paid $150,000 to the State of California Department of Insurance Fraud Division for their costs of investigation.
Under the terms of the plea agreement, Bacino will also be ordered to pay $210,000, and Fish $390,000, to the California Franchise Tax Board in unpaid taxes.
As part of the negotiated settlement, more than $60 million in liens and bills pending in the workers’ compensation system were dismissed and the defendants’ waived all rights to any financial benefit.
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