Seven indicted over alleged multimillion worker’s comp fraud

The seven purportedly billed insurers for $98 million in workers’ comp claims

Workers Comp

By Lyle Adriano

A Riverside County grand jury has indicted seven Southern California residents who have allegedly defrauded insurance companies for $98 million in workers’ compensation claims, reported The Press Enterprise.

The indictments are anticipated to lead to prosecution against the defendants. A number of the defendants were charged back in 2014, but have yet to face a preliminary hearing. With the indictment, however, prosecutors can bypass the preliminary hearing and put the accused on trial.

According to the Riverside County District Attorney’s Office, chiropractor and Riverside native Peyman Heidary, 45, hatched a workers' compensation fraud ring that involved various clinics in Riverside, Orange and Los Angeles counties; this racket defrauded 18 insurers.

Prosecutors say that of the $98 million billed since 2009, at least $12.4 million was paid out.

“Heidary instructed his employees to purposely conduct batteries of unnecessary tests including MRIs and sleep studies with the intent of billing insurance companies an amount well beyond what was medically necessary or indicted,” authorities claimed in a court document seeking steeper bail and a hearing in an attempt to prevent the defendants to post bail with allegedly stolen money.

The court documents further elaborated that the fraud ring would present inflated bills to the insurers of the patient’s employers. If an insurer refused to pay a bill, it can face a lien and fines from the state. Desperate companies might have settled the illegal bills or liens to avoid paying for fines.

The grand jury handed down two indictments. The first replaces the 2014, and names Heidary and three other accomplices. They face a combined total of 69 felony counts including conspiracy to commit insurance fraud, making a false insurance claim, making a false statement for the purpose of obtaining workers compensation benefits, money laundering, practicing medicine without a license, and capping; plus one misdemeanor count of unlicensed practice of law.

The second indictment charges three other accomplices who were medical providers employed by Heidary with 38 felony counts, including conspiracy to commit insurance fraud, making a false insurance claim, making a false statement for the purpose of obtaining workers' compensation benefits and capping.

Heidary faces up to 97 years and 4 months in state prison if he is convicted as charged. His six accomplices each face up to 63 years and 4 months in state prison.

The defendants will appear for arraignment on Tuesday, June 7, in Riverside County Superior Court.
 

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