Medical Biller Allegedly Stole $1M in Workers’ Comp Payments

 

Major fraud uncovered in New York

  • A New Jersey man was arrested for allegedly stealing more than $1 million that was intended to be paid to doctors who provided medical care to injured workers covered under workers’ compensation.
  • Prosecutors said Amrish Patel, who provided billing services to a Brooklyn-based orthopedic surgery practice, allegedly submitted falsified claim forms to the New York State Insurance Fund to steal at least $1.1 million in workers’ comp reimbursements for himself.
  • Patel and his two companies — Medlink Services, Inc. and Medlink Partners, LLC — have been charged with 27 felony counts for the thefts they allegedly committed from January 2012 through January 2019.
  • Patel diverted payments that were intended for surgeons who provided health care services to workers’ compensation claimants.
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Farmers face challenge getting workers’ comp in Wisconsin

  • Wisconsin does not require farms with fewer than six employees not related to the owners to have workers’ compensation coverage.
  • The Wisconsin Farm Bureau Federation and Wisconsin Farm Bureau Federation also do not appear to track how many of Wisconsin’s 5,700 or so dairy farms fall into that category.
  • One study found that more than 23,000 agricultural workers in Wisconsin were exempt from workers’ compensation coverage in 2020.
  • The challenges of the workers’ comp exemption are compounded by limits on the federal government’s enforcement of occupational health and safety laws on these same small farms.
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New obligations to maintain employment for injured workers

  • British Columbia employers and injured workers now have a mutual duty to cooperate in the worker’s return to work.
  • They will need to establish and maintain communication as soon as practicable after the injury occurs; identify suitable work for the worker that, if possible, restores their pre-injury wages; and apprise WorkSafeBC of the worker’s return to work or continuation of work.
  • Either party may request that WorkSafeBC investigate a failure to cooperate, and WorkSafeBC may impose remedies, including reducing or suspending payments of compensation to the worker until they comply with their obligations.
  • This duty to cooperate applies to workers who sustained injuries no earlier than Jan. 1, 2022, except that the obligation to contact applies as soon as practicable after Jan. 1, 2024.
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Railway workers’ claim denied

  • The U.S. Court of Appeals for the Sixth Circuit has denied compensation to Joseph B. Mattingly, a worker who suffered a leg amputation as a result of a fall at a railroad construction site.
  • The compensation was sought under the Federal Employers Liability Act (FELA), a federal law designed to protect and provide compensation for railroad workers injured on the job.
  • Mattingly’s claim was grounded on the belief that his employer, R.J. Corman Railroad Services LLC, was part of a railroad operation company, thereby making him eligible for FELA benefits.
  • However, a three-judge panel from the Sixth Circuit in Cincinnati unanimously determined that Mattingly’s employer did not qualify as a railway.”
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