A $25-Million Work Comp Fraud Revealed

Nine individuals have recently been arrested for their involvement in a complex fraud that has damaged over 230 workers’ compensation carriers and self-insured employers. The Department of Insurance detectives conducted the investigation and the arrest in which it turned out that a company called G&G Interpreting Services fraudulently charged insurance companies almost $25 million for services rendered in cases of injured workers with Latino last names. The defrauding company was led by siblings Francisco Javier Gomez, Jr. and Angela Rehmann.

For more than 4 years, G&G Interpreting Services, who offered translation services for Spanish, have been billing for their services supposedly delivered in clinics where most personnel spoke Spanish and didn’t require help with interpreting. In other clinics in which the company allegedly provided their services 13 doctors were proficient in Spanish.

Insurance Commissioner Dave Jones has commented this case by pointing out that a lot of people mistakenly think there is no victim in an insurance fraud. Jones stated that fraudulent billing results in everyone paying up.

G&G Interpreting serviced injured workers who received medical care through the workers’ compensation system across Los Angeles County and Southern California. They issued fraudulent bills in San Diego, San Bernardino, Orange, Riverside, Los Angeles, Santa Barbara and Ventura.

The 83,411 occasions on which they delivered their supposed services total over 12 working hours a day, which exceeds the opening hours of the clinics. The company also charged $422,000 for services executed by a translator who was at that moment serving time in state prison.

The interpreting company changed their name in August 2012 from G&G Interpreting to American Liberty Interpreting.

The operation was aided by California Highway Patrol and two district attorney offices from the Riverside County and San Bernardino County. Los Angeles County District Attorney’s Office will be the prosecution in the case.

A few months back, in October 2015, Commissioner Jones received almost $35-million worth of grants that were funded through employer assessments and distributed to 37 district attorney offices in 42 California counties. Jones stated then that work comp frauds were draining the state economy. The grants were specifically aimed at medical provider fraud, employer defrauding employee, claimant fraud, employer premium fraud, insider fraud and the intentionally uninsured working in the underground economy.

To remind the reader, Department of Insurance established The Workers’ Compensation Fraud Program in 1991. The legislation proclaimed work comp fraud a felony and set up Fraud Assessment Commission to fund enforcement and prosecution activities.

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