A San Diego neurosurgeon was acquitted Thursday of conspiracy to commit workers’ compensation insurance fraud, but jurors split on another felony count of false or fraudulent claims.
A hearing is scheduled for Jan. 29 for a motion to dismiss the remaining felony count against Dr. Vrijesh Shantanu Tantuwaya. Jurors split 7-5 for acquittal on the remaining felony count.
Tantuwaya had faced 13 felony counts before his preliminary hearing, but all but two were dismissed before trial.
Co-defendants Robert Young Lee, David Wayne Fish and Martin James Brill await trial. They are due in court for a pretrial hearing Friday in the Central Justice Center in Santa Ana.
Tantuwaya owns the medical groups Injured Workers Medical Group and his own practice.
Lee, Fish and Brill formed Southern California Injured Workers, a medical management company, which “purportedly provided administrative, billing and collection services to medical groups,” prosecutors said in a trial brief for Tantuwaya.
Fish, who was banned from the state’s workers’ compensation system because of a prior conviction, “orchestrated a massive referral scheme implemented with Dr. Tantuwaya and others,” prosecutors alleged.
Fish is accused of paying for patients to be referred to Southern California Injured Workers, which then directed patients to be treated by four medical groups, including Tantuwaya’s, prosecutors said.
Prosecutors alleged it was a “kickback scheme,” which guaranteed patient referrals to the owner of certain clinics where Tantuwaya had office space and staffing with Southern California Injured Workers providing scheduling, staffing and billing, prosecutors said.
Prosecutors accused Tantuwaya of receiving 5% of collections for patients referred by the medical group.
“The scope of the scheme was massive,” prosecutors said. State officials say there were $23 million in liens outstanding from Tantuwaya’s medical group.
Fish was twice convicted for workers’ compensation fraud and has pled guilty in a federal case in New Jersey, prosecutors said. Brill is an attorney, who invested in Southern California Injured Workers, and Lee is the chief executive of the medical group, prosecutors said.
The defendants formed their medical group in 2020 and patients were seen for chiropractic and acupuncture.
They are accused of billing nearly $100 million to multiple insurance carriers and were illegally paid referral fees from medical and pharmaceutical providers, prosecutors said.
Tantuwaya’s former attorney, Scott Simmons, issued a statement when the doctor was charged saying he was not involved in the alleged fraud scheme. Simmons said the doctor was a victim of fraud himself and sued the medical group formed by Bill, Lee and Fish.
The defendants were accused of billing nearly $100 million to multiple insurance carriers and illegally paid referral fees from medical and pharmaceutical providers, prosecutors said.
Efforts to reach Tantuwaya’s current attorney, John Barnett, were not immediately successful.