Health Care Fraud: Ronald Grusd And His Corporations Sentenced For Fraudulently Bill Insurance Companies Over $22 Million For Medical Services

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<h2>Beverly Hills Doctor Sentenced to 10 Years in Custody for Massive Workers’ Comp Scheme<&sol;h2>&NewLine;<p>SAN DIEGO – Beverly Hills Radiologist Ronald Grusd and two of his corporations&comma; California Imaging Network Medical Group and Willows Consulting Company&comma; were sentenced in federal court today after a jury trial in December resulted in convictions on 39 felony fraud counts&period;<&sol;p>&NewLine;<p>U&period;S&period; District Judge Cynthia A&period; Bashant imposed a sentenced of 10 years in custody and a fine of &dollar;250&comma;000&comma; and remanded Dr&period; Grusd into custody&period; His companies&comma; California Imaging Network and Willows Consulting Company&comma; were each required to pay a &dollar;500&comma;000 fine&comma; and an additional &dollar;15&comma;600 in special assessments&period;<&sol;p>&NewLine;<p>According to evidence presented at trial&comma; Dr&period; Grusd and his companies <strong>paid kickbacks<&sol;strong> for patient referrals from multiple clinics in San Diego and Imperial counties in order to <strong>fraudulently bill insurance<&sol;strong> companies over &dollar;22 million for medical services&period;<&sol;p>&NewLine;<p>Dr&period; Grusd negotiated with various individuals&comma; including a primary treating physician&comma; the payment of kickbacks for the referral of workers’ compensation patients for various medical services&comma; including MRIs&comma; ultrasounds&comma; Shockwave treatments&comma; toxicology testing and prescription pain medications&period; After the patients were referred for the treatment or service&comma; one of Dr&period; Grusd’s companies&comma; California Imaging Network Medical Group&comma; would <em>fraudulently bill insurance<&sol;em> companies for the procedures&comma; concealing from both the patients and the insurers that substantial <em>kickbacks<&sol;em> had been paid in violation of California law&period; Another of Dr&period; Grusd’s companies&comma; Willows Consulting Company&comma; funneled the <strong>kickback payments<&sol;strong> to those directing the referral of the patients from the various clinics&period; Records presented at trial showed that Dr&period; Grusd paid over &dollar;100&comma;000 in bribes to secure the billings for hundreds of patients&comma; with bribes paid on a per-patient or per-body-part formula&period;<&sol;p>&NewLine;<p>Dr&period; Grusd and the corporations were originally indicted by a federal grand jury in November 2015&comma; when the U&period;S&period; Attorney’s Office and the San Diego District Attorney’s Office&comma; working in conjunction with the Federal Bureau of Investigation and the California Department of Insurance&comma; announced multiple arrests arising from a long-term&comma; proactive health care fraud investigation targeting corruption and fraud in the California Workers’ Compensation system&period;<&sol;p>&NewLine;<p>Grusd’s practice&comma; California Imaging Network Medical Group&comma; operated clinics throughout California in San Diego&comma; Los Angeles&comma; Beverly Hills&comma; Fresno&comma; Rialto&comma; Santa Ana&comma; Studio City&comma; Bakersfield&comma; Calexico&comma; East Los Angeles&comma; Lancaster&comma; Victorville and Visalia&period;<&sol;p>&NewLine;<p>In imposing sentence&comma; District Judge Bashant expressed concern that by paying incentives&comma; Dr&period; Grusd applied pressure on the referring physician&comma; and &OpenCurlyDoubleQuote;made it highly questionable if all services were necessary&comma;” a harm that the laws were designed to prevent&period;<&sol;p>&NewLine;<p>Judge Bashant found that Dr&period; Grusd &OpenCurlyDoubleQuote;clearly knew what he was doing&period;” Dr&period; Grusd&comma; who had testified as to his extensive education&comma; training&comma; and expertise as a highly-decorated radiologist&comma; claimed on the witness stand at trial that he was confused and did not know that what he was doing was illegal&period; Judge Bashant rejected this view&comma; stating that Dr&period; Grusd was someone who decided to &OpenCurlyDoubleQuote;find a way to defraud…then act dumb on the witness stand” when he got caught&period; She imposed a sentencing penalty for Obstruction of Justice&comma; finding that Grusd unequivocally committed perjury and lied at trial&period; The judge said she was concerned about the need for both general and specific deterrence&colon; general&comma; because health care fraud is an area where criminals are rarely caught&comma; requiring a significant consequence in order to deter other would-be criminals&period; In this case&comma; specific deterrence was also applicable&comma; because&comma; in her view&comma; there was a risk that Dr&period; Grusd could engage in further unlawful conduct in the future&period; &OpenCurlyDoubleQuote;Dr&period; Grusd&comma;” she noted&comma; was someone who would &OpenCurlyDoubleQuote;act smart enough to pull the wool over everyone’s eyes&period;”<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;A patient entrusts his life to his physician&comma;” said U&period;S&period; Attorney Adam Braverman&period; &OpenCurlyDoubleQuote;A doctor’s medical decisions should be based on the best interest of the patient&comma; not the highest bidder&period; The court recognized that Dr&period; Grusd perverted that sacred relationship by buying and selling patients – oftentimes on a per-body-part basis – to fuel his personal lifestyle&period;”<&sol;p>&NewLine;<p>U&period;S&period; Attorney Braverman commended the efforts of the Federal Bureau of Investigation and the California Department of Insurance to investigate these offenses&comma; and thanked San Diego District Attorney Summer Stephan and her office for collaborating with the United States Attorney’s Office on this investigation&period;<&sol;p>&NewLine;<p>San Diego FBI Special Agent-In-Charge John A&period; Brown applauded today&&num;8217&semi;s sentence as indicative of how the insidious malignancy embodied by the payment of illegal bribes to and from medical providers seriously degrades the patient-physician relationship and places patients at risk&period; &OpenCurlyDoubleQuote;Operation Backlash exemplifies the positive impact the Federal Bureau of Investigation&comma; working side by side with our investigative partners&comma; the California Department of Insurance&comma; and the San Diego District Attorney&&num;8217&semi;s Office&comma; can have against those medical service providers who so easily replace honest patient care with greed&period; The FBI will continue to leverage these partnerships to expose these schemes and hold physicians and allied medical professionals accountable&period;”<&sol;p>&NewLine;<p>Anyone with information about healthcare fraud may call the FBI at 1-800-CALL-FBI&comma; or 1-800-225-5324 or the California Department of Insurance’s toll-free fraud hotline&comma; 800-927-4357&period;<&sol;p>&NewLine;<p><strong>DEFENDANTS Case Number&colon; 15cr2821-BAS<&sol;strong><&sol;p>&NewLine;<p>Ronald Grusd                                                      Los Angeles&comma; CA<&sol;p>&NewLine;<p>California Imaging Network Medical Group     Incorporated in 2007<&sol;p>&NewLine;<p>Willows Consulting Company                            Incorporated in 2011<&sol;p>&NewLine;<p><strong>SUMMARY OF CHARGES<&sol;strong><&sol;p>&NewLine;<p>Conspiracy to Commit Honest Services Mail Fraud&comma; Mail Fraud&comma; Wire Fraud&comma; and Health Care Fraud&comma; in violation 18 U&period;S&period;C&period; 1349<&sol;p>&NewLine;<p>Maximum Penalty&colon; 20 years in custody&semi; &dollar;250&comma;000 fine&comma; or twice the pecuniary gain or loss&semi; three years’ supervised release&semi; restitution to victims of the offense&semi; forfeiture<&sol;p>&NewLine;<p>Honest Services Mail and Wire Fraud&comma; in violation of 18 U&period;S&period;C&period; Secs&period; 1341&comma; 1343 and 1346 &lpar;18 Counts&rpar;<&sol;p>&NewLine;<p>Maximum Penalty &lpar;each count&rpar;&colon; 20 years in custody&semi; &dollar;250&comma;000 fine or twice the pecuniary gain or loss&semi; three years’ supervised release&semi; restitution to victims of the offense&semi; forfeiture<&sol;p>&NewLine;<p>Health Care Fraud&comma; in violation of 18 U&period;S&period;C&period; 1347&comma; &lpar;14 Counts&rpar;<&sol;p>&NewLine;<p>Maximum Penalty &lpar;each count&rpar;&colon; 20 years in custody&semi; &dollar;250&comma;000 fine or twice the pecuniary gain or loss&semi; three years’ supervised release&semi; restitution to victims of the offense&semi; forfeiture<&sol;p>&NewLine;<p>Travel Act&comma; in violation of U&period;S&period;C&period; 1952 &lpar;6 Counts&rpar;<&sol;p>&NewLine;<p>Maximum Penalty&colon; Five years in custody&semi; &dollar;250&comma;000 fine or twice the pecuniary gain or loss&semi; three years’ supervised release&semi; restitution to victims of the offense&semi; forfeiture<&sol;p>&NewLine;<p><strong>INVESTIGATING AGENCIES<&sol;strong><&sol;p>&NewLine;<p>Federal Bureau of Investigation<&sol;p>&NewLine;<p>San Diego County District Attorney’s Office<&sol;p>&NewLine;<p>California Department of Insurance<&sol;p>&NewLine;<p>&nbsp&semi;<&sol;p>&NewLine;<p><a href&equals;"https&colon;&sol;&sol;www&period;justice&period;gov&sol;usao-sdca&sol;pr&sol;beverly-hills-doctor-sentenced-10-years-custody-massive-workers-comp-scheme">Original PressReleases&&num;8230&semi;<&sol;a><&sol;p>&NewLine;

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