Investigators in San Diego County are still trying to sort through the details of what could be the biggest workers’ compensation fraud case in the state. Yesterday they announced 13 indictments against seven different California healthcare professionals after they had already indicted several lawyers and doctors for their role in the kickback scheme.

The newly indicted defendants were chiropractors, a radiologist, a pain management physician, a medical equipment provider, a medical clinic administrator and a medical marketer. They are charged for their involvement in a kickback scheme where they were referring patients to receive certain health services and then paid for their referrals. The kickbacks totaled $450,000 and they created millions of dollars of fraudulent workers’ compensation claims.

Defendants and corporations named in this round of charges would recruit people to file workers’ comp claims, and then direct them to certain chiropractors. The chiropractors were happy to have all these new patients and to help the recruiters who referred them patients in the first place, the chiropractors would refer the patients to specific pain management or other kinds of treatments, have MRIs or echo cardiograms, or use other medical equipment from certain providers named by the recruiters so that the corporations in charge of these services would profit as well.

If chiropractors did not meet the patient service “quota” set by the recruiters, they would stop referring patients to that chiropractor until they met their quota of referrals for these other health services or paid the balance.

Kickbacks drive up workers’ comp insurance costs for everyone, and the ones who are profiting off of them can put their patients in danger for referring them to services they may not even need.

“Operation Backlash” was the investigation into this scheme, a coordinated effort between the Department of Insurance, FBI, U.S. Attorney’s Office and the San Diego District Attorney’s Office. Last November eight people were indicted and at least one chiropractor and workers’ compensation attorney have pled guilty to federal fraud charges.

The state’s Insurance Commissioner, Dave Jones, said that the scheme “bought and sold patients”.

“Workers’ compensation is designed to protect injured workers and legitimate businesses, not create a fraudulent profit center for providers bent on taking advantage of the system. Fraudulent enterprises like this create a multi-billion dollar drain on California’s economy,” he said.