It is hard to forget the onslaught of liens that had followed every single claim around for years. It wasn't so long ago that in SoCal any time you would C&R a claim, it could have anywhere from 10-20 liens behind it! This sentencing by the US District Court was very interesting -- one of the pharmacist's controlling New Age Pharmacy, who the US Attorney alleged netted over $211 Million in payments on compound drugs, was ordered to forefeit $1.4 million seized from bank accounts, about $150k in jewelry and watches, and $38k in US currency.
However, the most interesting part to me was that there is no restitution to carriers! Prosecutors found that it wasn't clear how much would've been paid for these compound meds if there were not kickback's involved, and it is unclear to what extent there was an increased amount of medically unnecessary recommendations.
We still see this over abundance of medical treatment in the WC field, while others fighting through UR to get what they might actually need. We'll have to keep referring potentially fraudulent actions to prosecutors-- in a world where pain is so subjective, the fight to contain abuse of the system continues.
Prosecutors said judges in other work comp fraud cases determined that carriers “were not owed restitution because, while there was evidence that the financial incentive did result in an increased number of medically unnecessary recommendations by the physicians, it was unclear to what extent that occurred.”