Indictments Unsealed in $17M California Workers’ Comp Scam

June 15, 2011

Four people, including a radiologist and neurologist, are facing hundreds of criminal charges in a $17 million workers’ compensation insurance fraud scheme in Orange County.

Dr. Sim Hoffman of Newport Beach, neurologist Dr. Thomas Heric of Malibu and two other staffers are accused of overbilling for unnecessary procedures, according to the indictment unsealed Monday.

Hoffman, a radiologist who owns three medical testing centers in Buena Park, faces 883 felony counts of insurance fraud, and one count of aiding and abetting the unauthorized practice of medicine. He faces two to 892 years in prison if convicted.

Messages seeking comment were left for Hoffman at Advanced Professional Imaging and for Heric at Better Sleeping Medical Center late Monday.

Orange County District Attorney Tony Rackauckas said Hoffman was the “mastermind of this medical mill.”

“He is charged for using patients as props in order to bilk the system by overbilling the insurance companies,” Rackauckas said.

At a nerve testing center owned by Hoffman, patients underwent painful testing that cost $330 instead of a much less invasive exam that cost $35, he said. Only two doctors in California are qualified to perform the more expensive and invasive test.

“Hoffman didn’t just bill for one Single Fiber EMG per patient. According to his bills, the patients went through this painful procedure over 20 times each,” the prosecutor said.

Heric, a neurologist, worked for Hoffman at the Better Sleeping Medical Center. He is charged with 296 counts of insurance fraud and one count of aiding and abetting the unauthorized practice of medicine. He faces two to 315 years in prison if convicted.

The indictment was dated May 11 but unsealed Monday.

Arraignment for the four defendants was set for June 22.

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