NSC Business and Industry Division news State programs Workers' compensation

California suspends nearly 200 medical providers from state workers’ comp system

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Photo: syahrir maulana/iStockphoto

San Francisco — The California Department of Industrial Relations’ Division of Workers’ Compensation has suspended 178 medical providers from its workers’ comp system during the first eight months of the year.

According to a DIR press release, providers are suspended from the system when they’ve been convicted of fraud-related crimes, have been suspended from Medicare or Medicaid programs because of fraud or abuse, or have lost their professional license. Nearly 650 providers have been suspended from the system since 2017.

For providers convicted of a fraud-related crime in 2022, the Division of Workers’ Compensation has begun lien consolidation cases estimated at $75 million. During their lien hearings, providers have the opportunity to prove their billing is legitimate. If they can’t prove their case, the liens are dismissed.

Since 2017, 63,000 liens with an estimated value of almost $775 million have been dismissed.

Currently, 86 providers facing criminal charges have 516,000 liens that have been stayed. A stay prevents the providers from seeking payment for liens while a criminal case is pending.

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