You may have noticed receipt of a large number of “Supplemental Lien and 4903.05(c) Declaration” forms submitted by various lien claimants over the last couple months. Many have wondered the purpose of these lien forms.
Pursuant to Labor Code section 4903.05(c) amended as part of Senate Bill 1160 on January 1, 2017, all lien claimants who filed a lien between January 1, 2013 and December 31, 2016 and paid a filing fee, were required to fill out and file these Supplemental Lien Forms by July 1, 2017.
If a lien claimant did not timely file the requisite Supplemental Lien Form, the DWC has now dismissed the lien by operation of law. To see whether a lien has been dismissed, search EAMS. Under the “DWC Proceeding” heading, the status will state “DISMISSED PURSUANT TO 4903.05(C).”
The purpose of the amended LC 4903.05(c) was part of the effort of Senate Bill 1160 to combat fraud. Not only have thousands of liens now been dismissed, but the DWC has also suspended several physicians/practitioners/providers from participating in the workers’ compensation system.
A list of the suspended providers can be found here:
Liens under these providers are currently stayed and/or pending dismissal in a special lien proceeding. You therefore do not need to negotiate any stayed or dismissed liens.
Per LC 139.21(a), a suspended providers list is based on providers who meet the following criteria:
- “Conviction of felony or misdemeanor that (i) involves fraud or abuse of the Medi-Cal or Medicare program, workers’ compensation system, or any patient; (ii) relates to the individual’s medical practice as it pertains to patient care; (iii) is a financial crime relating to Medi-Cal, Medicare, or the workers’ compensation system; or (iv) is otherwise substantially related to the qualifications, functions, or duties of a provider of services.
- Suspension due to fraud or abuse from the federal Medicare or Medicaid programs.
- Surrender or revocation of the individual’s license, certificate, or approval to provide health care.”
Suspension from participating in the workers’ compensation system means that they are unable to provide or obtain payment for any treatment, evaluation, or other service related to a claim for workers’ compensation.
Aside from physicians and providers, there has also been a crackdown on fraud against several well-known applicant attorneys. In June 2017, the Orange County District Attorney’s office charged ten attorneys, the largest number of attorneys charged in one case in Orange County history, for participating in an alleged multi-million dollar workers’ compensation insurance referral scheme.
Charged attorneys are listed here along with the charged cappers and details of the alleged scheme: http://orangecountyda.org/civica/press/display.asp?layout=1&Entry=5203
The charged attorneys are still currently practicing law and their firms are still up and running business as usual until further notice.
More developments on criminally charged providers, lien dismissals, and charged attorneys will undoubtedly continue to unfold.
In summary, do not forget to check EAMS on newly dismissed lien claimants pursuant to LC 4903.05(c), or for lien claimants who have now been stayed. Physicians and attorneys who have been charged with fraud but who have not been convicted, are still in practice and are still involved in the workers’ compensation system. It is important to be aware of the charges, but otherwise any cases you have with these attorneys have not been affected by the charges to date. Physicians who have been charged with fraud but not yet convicted are still able to participate in the workers’ compensation system unless they are on the list of actual suspended providers as noted above.
* Note – Not all providers who have been charged with fraud have actually been convicted yet. Here is a list of all criminally charged providers whose liens have been stayed pursuant to Labor Code section 4615 as of June 16, 2017:
https://www.dir.ca.gov/Fraud_Prevention/List-of-Criminally-Charged-Providers.pdf. Many of these providers are still practicing and treating in the workers’ compensation system.
Questions? Do not hesitate to contact me.
Natalie W. Houng is an associate attorney based out of Bradford & Barthel’s Los Angeles location. She can be reached at firstname.lastname@example.org or (310) 981-5004.
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