California Professional License Defense Blog

Dr. Glen R. Justice, a prominent Orange County physician has agreed to plead guilty to defrauding insurance companies for injectable cancer medication that he never provided. Prosecutors said, Justice, the former director of the cancer center at Orange Coast Medical Center and the Pacific Coast Hematology/Oncology Medical Group received up to $1 million for the false claims.

Dr. Justice, of Corona del Mar has agreed to plead guilty to 5 counts of heath care fraud which caries a maximum 50 years in prison, $1.25 million fine and 3 years probation. According to the agreement, federal prosecutors will recommend a probationary sentence in lieu of prison. Justice is scheduled to be arraigned May 3, 2010.

Dr. Justice also faces discipline from the California Medical Board, however, an accusation has yet to be filed.

Attorney General Edmund G. Brown Jr. has filed criminal charges against the former manager of a Mount Shasta-based medical clinic who filed "bogus claims" under Medi-Cal for medical services that were never performed.

Denise Fairhurst, of Redding, was arrested Wednesday on five criminal counts of grand theft, insurance fraud and submitting false claims to the government. She is being held on $1 million dollar bail.

"Fairhurst ran a health clinic that was losing money and in danger of closing because of widespread financial mismanagement," Brown said. "To keep her operation afloat, she submitted bogus claims to Medi-Cal and in the process violated California law."

Brown's complaint, alleges that between January 2004 and December 2007, Fairhurst, billed Medi-Cal $2.2 million for services not rendered to beneficiaries to help pay operation and management. In addition, Fairhurst used $33,492 of the funds to pay personal credit card bills. If convicted, Fairhurst faces up to five years in state prison.

Ira Messing, 61 owner of Hall of Fame Design and Remolding was sentenced to 3 years and 4 months in prison and ordered to pay $845,000.00 in victim restitution. Messing plead to 15 felony counts of diverting construction funds when he contracted with 15 homeowners to install sunrooms in their homes. Instead of using the money to complete the construction projects, Messing used their money to complete older jobs.

Messing was arrested in Kansas and waived extradition to Orange County where he was sentence.

University of California, Irvine anesthesiologist, Dr. Peter H. Breen has been accused by state regulators of gross negligence and incompetence after allegedly falsifying medical records and assigning a resident to work in the operating room when Dr. Breen’s and was in a cast.

Dr. Breen was the former head of the anesthesiology department at the Orange County University, however, he still works at the UCI hospital. The California Medical board has leveled the allegations against the Irvine physician and Dr. Breen faces suspension or revocation.

The California Medical Board reported Dr. Paul Lessler, 70 surrendered his California medical license after pleading guilty to Medicare fraud.

Dr. Lessler, of Newport Beach operated a medical clinic, University Pain Specialists, where he hired recruiters to find patients to receive unnecessary respiratory treatments. Prosecutors alleged the Orange County doctor’s scam billed Medicare $12 million for such treatments. In May 2007, Lessler pleaded guilty to three felony counts of conspiracy and health care fraud charges.

As a result of his medical insurance fraud convictions, the California Medical Board sought to revoke Lessler’s medical privileges. In July, Lessler agreed to give up his California Medical License with a signed stipulation with the board.

Vinod Patwardhan, an Upland doctor was charged with allegedly smuggling unapproved drugs into the United States from India. Dr. Patwardhan is a board certified physician who specializes in oncology and hematology. His hospital privileges include hospitals in the cities of Pomona, Chino, Montclair and Ontario.

According to the federal complaint, Patwardhan treated over 30 patients being treated for cancer by administering partial doses of illegal drugs as part of their chemotherapy. His employees allegedly told authorities that instead of treating his patients by full doses, he would administer half doses and share single vials between two patients.

Patwardhan did tell authorities that he has brought over hundreds of thousands of dollars from India and Honduras. The narcotics were allegedly transferred in a gym back and Nordstrom bags.

It is speculated that Dr. Patwardhan saved between $150-$200 per vial or over $1 million over the past six to seven years.

Dr. Patwardhan was charged with one count of delivering misbranded drugs into interstate commerce with the intent to defraud or mislead. If convicted, he could receive a maximum of three years in federal prison. Patwardhan was released on $2 million bond his arraignment is set for Sept. 17.

It is unclear if his hospital privileges have been suspended or what action the California Medical Board is taking.

Dr. Kevin Brown was arrested by the Los Angeles Police Department on accusations that he molested eight patients, one of them being 15. Dr. Brown was arrested July 8, 2008 and was charged with sexual battery and exploiting his position as a physician involving incidents relating to a female patient and under cover police officer posing as a patient.

Dr. Brown is widely respected in the medical community for his charitable contributions including his disaster-relief medical charity, Urban Health Institute. Those closest to Brown are shocked and vow to stand behind him.

The Los Angeles County District Attorney’s Office filed 19 felony counts against Brown, including a lewd act on 15 year old, rape, sexual battery and fraud. Currently, Brown is being investigated by California’s Bureau of Medi-Cal Fraud and Elder Abuse in an alleged health care fraud scheme although he has yet to be charged with any criminal charges. It is unclear whether the California Medical Board has taken any action against Dr. Brown’s license to practice medicine.

Dr. Brown’s Los Angeles criminal defense lawyers declined to comment. Dr. Brown’s bail was set at $4 million due to his connections to Bermuda and their lack of extradition.

Dr. Christopher Thompson, a Brentwood doctor was charged with abruptly stopping his car in front of two cyclist, in what might have been a road rage incident. Dr. Thompson has previously been investigated for a similar road rage incident against cyclist in March of 2008, according to the Los Angeles Police Department.

Dr. Thompson faces two felony counts of reckless driving causing injury and battery causing serious bodily injury in an accident that occurred July 4, 2008. The Los Angels County District Attorney’s Office is alleging that Thompson slammed on his brakes directly in front of two bicyclist who were riding downhill on Mandeville Canyon Road. The bicyclist, without time to stop or avoid Thompson’s red Infiniti collided with the vehicle with one rider crashing through the read window and the other crashing to the pavement.

Ron Peterson, 40 who crashed through the window suffered broken teeth, broken nose and cuts to the face. Christian Stoehr, 29 suffered a shoulder separation which will require surgery. Both riders describe riding down the hill when they heard a honk and someone yell profanities at their direction. The car that honked, then pulled right in front of them and immediately slammed on their brakes.

Thompson, who lives on Mandeville Canyon Road is an owner of a medical documentation company in Woodland Hills. Thompson is out on bail and is awaiting a court date on August 1, 2008 where he will be arraigned on the felony complaint. If convicted, Thompson faces up to 7 years in prison.

In addition to any criminal charges, Dr. Thompson also faces discipline by the California Medical Board. Such discipline can include license suspension all the way to total revocation of all privileges to practice medicine in the state.

Roy Chester Dickson of Yorba Linda, California was indicted by the Orange County Grand Jury on 106 felony counts including money laundering, grand theft, insurance fraud and making false or fraudulent claims. Dickson, an attorney is accused of being a player in the Unity Outpatient Surgery Center scam where three Southern California physicians, Dr. Mario Rosenberg, Dr. Michael Cheeluen and Dr. William Wilson Hapton Jr. are also charged. According to prosecutors, Dickson has been involved in similar criminal conduct in other surgery center clinics in southern California.

Also indicted was Andrew Robert Harnen, the surgery center accountant and bookkeeper. Harnen is accused of filing false tax returns and failing to report over $6 million, paying the doctors and recruiters for their participation in the Unity scam.

According to prosecutors, Unity is the biggest insurance fraud scam in the history of the U.S. with a loss of over $150 million. In this particular scam, the defendants are accused of recruiting over 2,800 healthy people, who from August 2002 to April 2003 traveled to Buena Park to undergo unnecessary medical procedures. In return, the patients received payments between $300-$1,000 per procedure.

Dickson and Harned are being held on $2 million bail and are scheduled to appear in court for their arraignment on July 10, 2008.

San Francisco transplant surgeon Dr. Hootan Roozrokh is being accused by the California Medical Board of administering large quantities of pain medicine to a prospective organ donor. The allegations stem from the death of 25-year-old Ruben Navarro who was going to have his organs donated upon death. Under state law, a transplant physician cannot be in the operating room of a potential donor until that donor is pronounced dead. The state board complaint further alleges Dr. Roozrokh was "actively monitoring the patient's vital signs for a determination of death."

In addition to the actions taken by the California Medical Board, Dr. Roozrokh’s also faces criminal charges in San Luis Obispo for felony dependent adult abuse in the death of Mr. Navarro. If convicted at trial, Dr. Roozrokh could be sentenced to prison.

Theodore Swain, 60 was sentenced to 24 years in state prison for stealing $7 million dollars in a Ponzi scheme bilking 100 investors in Southern California. In addition to his prison sentence, Mr. Swain was ordered to pay $6.7 million dollars in restitution to his victims.

Mr. Swain has had a “history of ripping people off with his worthless investment schemes,” says California Attorney General Edmund Brown. “Most recently, he convinced 99 consumers, including a doctor, lawyer and aerospace engineer, to invest tens of thousands of dollars in property which does not exist.”

Between 2003 and 2006, Mr. Swain convinced consumers to invest $1,000 to $1000,000 in mortgage certificates which never existed. Swain was able to manufacture documents, which promised 10% annual returns on real estate projects. “This was a very convincing Ponzi scheme,” said Deputy Attorney General Tawnya Boulan who prosecuted the case jointly with the California Department of Corporations. “Swain was very persuasive and ripped off sophisticated investors by maintaining an appearance of success.”

As is typically done in Ponzi schemes, Swain used new investor capital to pay older investors, allowing him to continue with the fraud for several years. Swain also failed to disclose pertinent investor information allowing his investors to make informed decision in violation California law.

A San Diego jury found Mr. Swain guilty of 15 counts of fraud, 6 counts of grand theft, 3 counts of securities fraud and 3 counts of elder financial abuse. In addition to the substantive charges, Mr. Swain was convicted of sentencing enhancements related to securities fraud called white collar crime enhancements.

California Attorney General Edmund Brown announced that the state of California was going to create an online database to track prescription drug history in an effort to curb abuse by drug dealers and people who go to several doctors to get several dangerous prescription drugs.

The prescription drug database will give California pharmacists and physicians a real time glimpse of patients prescription history. This technology will help fight prescription drug abuse in California and reduce a financial burden on medical insurance companies. In addition, it will reduce doctor shopping for those who are addicted to prescription drugs and go to several doctors for the same prescription.

The new database named CURES or Controlled Substance Utilization Review and Evaluation System is set to launch in 2009 at a cost of 3 ½ million dollars. While California does have the CURES system in place currently, it is not an online database and can take days for pharmacists and physicians to check a patients drug history. The CURES database carries information of over 86 million schedule II,III, and IV prescription drugs such as Morphine, Vicodin, Oxycodone, Methadone, Codeine

A representative of the California State Board of Pharmacy is quoted as saying "The California State Board of Pharmacy has long been a strong supporter of the CURES system. This new system will reduce drug diversion from pharmacies--it is an important enhancement to patient care and law enforcement."

Our Orange County, Ca law firm receives a lot of calls from physicians in Orange County, Los Angeles County, Riverside County, San Bernardino County and San Diego County who have either been arrested for a crime or have been convicted of a crime. The number one question is how their criminal case will effect their medical license and what actions the California Medical Board can take. So, it is worth mentioning again.

Physicians, like anybody, are susceptible to committing crimes including; DUI, Fraud, Illegally Prescribing Meds, Drug Possession and Domestic Violence, just to name a few. Each case is different and the Board reviews cases on an individual basis. They will review police reports and any supplemental material to determine if there is an underlying cause for the conduct such as alcohol abuse and DUI’s or financial difficulties and theft or fraud charges. They will also assess whether the physician is unfit or unworthy of a California Medical License.

The Board conducts their own investigation and may learn information that was not available or known at the criminal stages. This could mean office staff, nurses and colleagues are interviewed. This could mean random drug testing. This could mean taking business records from medical offices. As you can see, the discovery of incriminating evidence that can be used against you and your license is huge. It is critical that a medical license defense attorney is consulted during this process as it could mean the difference between keeping your license and losing your license. In fact, if a physician is arrested or being investigated by law enforcement for a crime, I would recommend hiring a criminal defense attorney in Southern California who also handles medical license defense cases. This would ensure both the physician and the medical license are protected at the earliest stages of the case.

Pilchman and Kay, PLC is an Orange County based criminal defense and professional license defense firm. We handle state, federal and medical board cases in Orange County, Los Angeles County, Riverside County, San Diego County and San Bernardino County. We welcome you to call us for a free consultation regarding any medical license or criminal defense case.

Attorney General Jerry Brown has shut down mortgage companies in Los Angeles and San Bernardino Counties for alleged predatory lending scams. Virtual Escrow, Olympic Escrow, National Mortgage, Lifetime Financial, Greenleaf Lending and Direct Credit Solutions are the companies named for participating in scams that could top more than $20 million.
In a time where the housing market is down, mortgage companies are attempting to gain business by using unconventional and illegal measures. Specifically, this investigation has uncovered information that many of the named companies were engaging in illegal tactics to initiate loans including psychological pressure, lies and even forged documents.
With California leading the nation in subprime lending, it is likely that additional companies particularly in Orange County might be named or investigated for mortgage fraud. As of 20007, authorities have initiated criminal investigations of many lenders including, New Century Financial Corp. an Irvine subprime lender who is now bankrupt.

Mortgage fraud has topped $1 billion in the past decade and California places 4th on a national list of mortgage fraud offenders for 2007. Beating out California is Florida at number 1, Nevada at number 2 followed by Michigan. FBI statistics show 46,700 mortgage fraud reports in 2007 alone, up 30% from last year. Common types of mortgage fraud include misrepresenting employment history, falsified tax returns, inflating income and providing false financial documents.

Orange County, California houses many of the top mortgage companies in the country. Therefore, many of these complaints and allegations are likely to find their way to the Orange County District Attorney’s Office, the California Department of Corporations, the California Department of Real Estate, the US Attorney or the California Attorney General’s Office.
If you are being charged with mortgage fraud in Orange County, Los Angeles County, Riverside County or San Bernardino County either as an applicant or as a licensed mortgage broker, you need to find a knowledgeable criminal defense lawyer who can guide you through the process and protect your rights. If you are not adequately represented you may increase your criminal exposure and possibly lose your brokers license.

The loss of your professional license can be devastating not only to you but to your family as well. Allegations of fraud in the mortgage industry alone may trigger reporting requirements. I cannot emphasize enough the need to contact a top criminal defense lawyer who can help you understand licensing laws and self-reporting statutes so you don’t lose your license.

California Attorney General Edmund Brown Jr. announced the arrest of several individuals in a massive medi-cal fraud scam in Los Angeles County. The defendants were arrested at the Downtown M Medical Clinic on Wilshire Boulevard and include: the clinic’s owner Dr. Peter Shrier, the office manager Ella Rozenberg, Ella’s husband Arkady Rozenberg, Dr. Anna Gravich, a physician who helped falsify medical records, and Anna’s husband, Gersha Gravich, who helped run the clinic. The others arrested were sidewalk solicitors who recruited the patients.

The defendants allegedly hired recruiters or “cappers” to solicit pregnant women to visit the Los Angeles clinic. The women were asked not to use their real names in exchange for $30 of free baby merchandise or the promise of medical services. In exchange, the recruiters were given $100 for every woman that visited the clinic.

The clinic targeted pregnant women so it could enroll them in special Medi-Cal programs for low income women. When enrolled in the program, doctors began to bill the State of California at a higher rate for temporary prenatal health benefits. The cost of these services ranged from $400-$500 per patient. Once these services were rendered, the women were told that if they wanted more money or benefits, they could re-enroll in the program using another alias.

The AG has estimated the loss relating to this medical insurance fraud case to be in excess of $2 million. Dr. Shrier, the Rozenbergs and the Graviches have all been charged with:
Penal Code Section 487(a)- Grand Theft
Penal Code Section 12022.6(a)(3)- Theft of more than $1.3 million
Welfare & Institutions Code Section 14107-Presenting false Medi-Cal claims.

As a result of being charged with several felony counts, Dr. Rozenberg and Dr. Shrier will also have to self-report to the California Medical Board. In California, anytime a physician is charged with a felony criminal charge, they must report this accusation to the medical board even if they plead not guilty at arraignment. Thus, both doctors will be fighting to maintain their professional license while these criminal charges are pending.

If you or someone you know has been arrested or questioned for a criminal charge, whether a misdemeanor or felony they should seek legal counsel immediately. The California Medical Board has clear rules on self-reporting criminal charges and ignorance is no defense.

Los Angels county District Attorney Steve Cooley held a news conference today discussing the more than 50 people who were charged in a $3 million dollar child-care fraud scam. Demetrius Eugene, 36 is the alleged ringleader and is accused of setting up 6 bogus child-care facilities under the name Home Sweet Home Day Care, Inc. around Los Angeles County and possibly other California counties.

Cooley said Eugene listed family and friends as child-care providers in a “welfare to work” program. This state run program pays day care providers for taking care of children for those on welfare so they can get back into the workforce. Eugene allegedly then recruited welfare qualified candidates in order to collect state funds. These candidates then signed fake attendance cards at the Los Angeles headquarters of Home Sweet Home in return for $300 per child.

Among those charged was Kmond Day, 32 who received his day care license shortly before he was convicted of drug trafficking and sent to prison. According to authorities, Day and his wife received over $400,000 in state funds.

Deputy District Attorney James Baker who is working on this case says this ring is one of hundreds of child-care fraud complaints referred to the Department of Pubic Social Services in the county.

The California State Contractors Licensing Board has recently added increased protection for consumers in Orange County, Los Angeles county or anywhere in California who are engaged in new construction or remodeling projects. Below are a few of the most important new laws for consumers to be aware, all taking effect January 1, 2008

- Business and Professions Code Section 125.6 prohibits discrimination by licensed contractors toward prospective clients. In addition to the already established discrimination based on race, color, sex. religion, ancestry, disability, marital status, natural origin this section also added clients medical condition and sexual orientation.

- Under California Civil Code Section 2782, General contractors and subcontractors working under a residential construction contracts can be held liable for construction defects, injury or negligence regardless of whether or not that language is included in the contract.

- Registrar of Contractors will be authorized to order restitution for any consumer who is an “injured party” resulting when a licensed contractor aides an unlicensed person or who allows an unlicensed person to use his or her license. Currently, licensed contractors who violate this law are already subject to civil monetary penalties and disciplinary action against their license pursuant to Business and Professions Code Section 7114.

- Landscape Contractors licensed by California Contractors State License Board will be able to enter prime contracts to construct and install outdoor cooking centers and fireplaces. This is provided that the projects are already included in the residential landscape project and the fireplace is not attached to the dwelling. Currently, landscapers are authorized to be the prime contractor for pool, spa or hot tub projects. BP 7027.5-

Business and Professions Code Section 802.1 (a)

The Medical Board of California, the Board of Psychology, the Dental Board of California, the Osteopathic Medical Board of California, the State Board of Chiropractic Examiners, the Board of Registered Nursing, the Board of Vocational Nursing and Psychiatric Technicians, the State Board of Optometry, the Veterinary Medical Board, the Board of Behavioral Sciences, the Physical Therapy Board of California, and the California State Board of Pharmacy shall be notified of the following:

(1) The bringing of an indictment or information charging a felony against a licensee.

(2) A conviction of the licensee by way of verdict of guilty, guilty plea, no contest plea of any felony or misdemeanor. A licensee must report only those misdemeanors that are substantially related to the qualifications, functions, or duties of the licensee.

Failure to make a report required by this section shall be a public offense punishable by a fine not to exceed five thousand dollars $5,000.

Most licensing agencies have not spelled out what misdemeanors are “substantially related to the qualifications, functions and duties” of the licensee. However, here are a few misdemeanors charges that would qualify:
Under the Influence of Narcotics
Possession of Narcotics
DUI
Theft or Fraud
Child Abuse- Physical or Sexual Abuse
Sexual Battery
Possession of Child Pornography
Indecent Exposure
Sexual Acts with Minors
Stalking
Filing False Police Reports

You have worked very hard to achieve academic and professional success. An arrest and/or possible conviction of a crime does not guarantee the loss of your license and your career. Often time, what happens in the criminal case will have a direct effect on the actions taken by the licensing agency. Attorneys can help you navigate the criminal court system with an eye on how to mitigate the sanctions taken against your license. So, if you find yourself in a situation where you have been charged with a crime, consult an attorney.

The Los Angeles Bureau of Narcotic Enforcement is ramping up its intense investigation into Southern California doctors that have been over prescribing pharmaceuticals including Oxycontin, Vicodin, Ritalin and other opiate-based narcotics. This year long investigation has uncovered at least one pharmacy in the Los Angeles/Orange County area who was proscribing over 2 million dollars worth of prescriptions from one local physician alone. The Pharmacy Board of California, the Medical Board of California, Medi-Cal Fraud and other local law enforcement agencies are currently prosecuting this and similar cases.

The BNE is required to investigate pharmacists, physicians, nurses and other people who use legal channels to procure pharmaceuticals and in turn sell them illegally. This task force is currently investigating other individuals in Orange County, San Bernardino County and Riverside County for obtaining prescription drugs unlawfully. The number of cases of pharmaceutical scams is increasing, likely the result of the internet.

In response to this problem, the BNE has established a Diversion Program to reduce the number of incidents of drug diversion. This includes increasing the number of agents to enforce the laws of illegally obtained prescriptions, including forged or counterfeit prescriptions, illegal online pharmacies and unlawful prescription writing by licensed physicians, nurses, psychiatrist, dentist, podiatrist, veterinarians, pharmacist and other licensed professionals.

If you are a physician practicing in Orange County, Los Angeles County, Riverside County, or San Bernardino County you need to know about Penal Code Section § 550(a)(5). Penal Code Section § 550(a)(5) makes it a misdemeanor or felony for any physician, nurse, dentist or any other medical or dental professional to knowingly prepare, make, or subscribe any writing with intent to present or use it in support of any false or fraudulent claim to an insurance company. This can include office visits, urine or blood tests, x-rays, body scans and even minor or major medical procedures that were not performed.

When it comes to your professional license, whether you are a licensed physician practicing in Southern California, a licensed dentist or orthodontist practicing in Orange County, a nurse practicing in Los Angeles or a licensed medical professional practicing in the Inland Empire your license may be in jeopardy if you are convicted of medical fraud or insurance fraud.

If you are arrested for Penal Code Section § 550(a)(5) anywhere in Southern California you may face the following:

Depending on the amount of fraud you could be charged with a felony or misdemeanor. If the fraud is over $400.00 it would be a felony and less than $400.00 would be a misdemeanor.

A Misdemeanor would mean you could possibly spend one year in county jail and a fine of $1,000.00. A Felony conviction would subject you to 2, 3, or 5 years in state prison plus a $50,000 fine or double the amount of fraud, whichever is greater.

If you are contacted by the district attorney’s office, California Medical Board, or other licensing agency you need to contact a medical license defense attorney prior to speaking to any investigating agency. Without proper legal representation, you may face permanent disbarment or revocation of your professional license not to mention possible jail/prison time and substantial fines and fees.

California physicians soon will be without the option of attending a drug and alcohol treatment program in lieu of any license sanctions or revocations. For the past 27 years, any physician practicing in Orange County or any other county in California was able to treat their addiction for substance abuse by enrolling in a treatment program under the direction of a case worker. Often times, any physician who participated in the diversion program did so anonymously, without the knowledge of the medical board. By allowing California physicians the comfort of knowing their rehabilitation was not going to compromise their license helped those in need seek help.

In Orange County, California there are many exceptional treatment programs that deal with substance abuse and mental health related issues. It is imperative for any physician who feels they need help in controlling their addiction to seek help before the California Medical Board finds them. If the medical board does become aware of any substance abuse issues, a physician will likely be investigated and possibly lose their license.

The impact on physicians practicing in Southern California is significant. Instead of seeking the treatment they need, many will deny the addiction. With this denial, the community for which these highly skilled professionals serve will be at risk. And once this risk is assessed, the California Medical Board will act. If any physician in Orange County, Los Angeles County, Riverside County or San Bernardino County receives a notice from the California Medical Board regarding possible sanctions, it is imperative to consult with an attorney who can help navigate these treacherous waters.