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Labor Code §139.21(a) provides for the suspension of physicians, practitioners, and providers from participating in CA ’s workers’ compensation system if they meet any of the following criteria: A. 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.* B. Suspension due to fraud or abuse from the federal Medicare or Medicaid programs. C. Surrender or revocation of the individual’s license, certificate, or approval to provide health care. A 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. *A physician, practitioner, or provider who has been suspended due to a conviction covered by paragraph (A) is also subject to having all pending lien claims consolidated and dismissed in a special lien proceeding, unless they can prove the liens did not arise from the conduct or activity that led to their suspension.
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AuthorHefley Law, APC Archives
September 2021
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