A neurosurgeon was among four charged in connection with a scheme involving nearly $100 million in fraudulent workers' compensation charges, The Los Angeles Times reported Oct. 13.
San Diego neurosurgeon Vrijesh Tantuwaya, MD, along with the alleged leader of the scheme, David Fish, of Laguna Niguel, Calif., and two others, allegedly organized a scheme to "control clinics and providers who would see patients, refer them to specific providers in order to receive illegal referral payments, and then unlawfully bill workers' compensation insurance companies for these services."
The allegations come at the end of a three-year investigation into Mr. Fish, who has twice been convicted of workers' compensation fraud and is banned for life from the California workers' compensation system, according to an Oct. 11 release from the Orange County District Attorney's Office.
Dr. Tantuwaya, Mr. Fish and their two co-conspirators allegedly formed a firm, called the Southern California Injured Workers, which offered medical management services including marketing, billing and collections, but was run by Mr. Fish.
The four alleged co-conspirators also formed a medical group called Injured Workers Medical Group, which was the main client for Southern California Injured Workers. Dr. Tantuwaya was the owner and CEO of this organization, according to the release.
Dr. Tantuwaya's attorney, Scott Simmons, maintained Dr. Tantuwaya's total innocence in a statement to the Times. Mr. Fish's attorney, Benjamin Gluck, also said that the charges were unfounded.
The four men are being charged with 13 separate felony counts, including violations related to client referral for compensation, conspiracy to commit a crime and insurance fraud.
All men have thus far pleaded guilty. If convicted, Mr. Fish would face a maximum of 18 years and four months in prison, and Mr. Tantuaway would face 13 years and four months in state prison. The other two men would face similar sentences.