The presentation of bills and reports generated by diagnostic radiology facilities catering to the auto bodily injury claimants and workers’ compensation applicants, and their attorneys, have been commonplace for decades. MRIs in the context of claims can serve as a gateway for additional and often unnecessary diagnostic studies and treatment, including surgery. The staggering charges on bills presented to carriers inflate special damages that drive the evaluation of claims. This class delves into the practice of MRI brokering – lay ownership of ostensible radiology practices, the creation of “sham” radiology practices, solicitation of claimants and applicants, contracts with diagnostic facilities and teleradiologists, steering patients to providers, financial arrangements, and the preparation and presentation of false bills and reports by unlicensed brokers. Most notably, this class will discuss the recent California District Court of Appeal opinion finding that the practice by laypersons of brokering patients under the guise of a legitimate radiology practice to be unlawful and the implications for carriers in their investigation of suspected fraudulent claims.
Maisie Sokolove
Tom Fraysse
Ryan Fawaz