NEWS RELEASE
Insurance Commissioner Poizner Announces Two San Diego
Men Plead No Contest in Workers' Compensation Fraud Cases
Duo Agree to Forgo $60 Million in Medical Liens and Bills Pending at WCAB
California Insurance Commissioner Steve Poizner today announced that David Wayne Fish, 47, of
San Diego and Birger Greg Bacino, 50, of Rancho Santa Fe, have plead no contest to felony
charges of compensation or inducement for referring clients for profit in a workers' compensation
scheme and agreed to release $60 million in medical liens and bills prior to entering their plea. They
will serve three years of probation.
Fish and Bacino are the principal owners of Premier Medical Management Systems Inc. The business
was charged with making false and fraudulent workers' compensation claims and filing false tax
returns. At its peak, Premier Medical owned and operated five clinics in the greater Los Angeles area
and contracted with more than 100 medical providers. More than
$60 million in liens and bills created by Premier Medical Management Systems Inc. were pending
before the Workers' Compensation Appeals Board (WCAB) and as part of the negotiated disposition,
Fish and Bacino agreed to drop those claims.
"Getting kickbacks for referring medical payments is illegal and drives up the costs in the system,"
Commissioner Poizner said. "Because of our work and that of the Los Angeles District Attorney's
office, we were able to prevent $60 million in fraudulent and unnecessary claims in being made. We
will continue to work hard to eliminate these unneeded costs to keep workers' compensation
insurance affordable."
A California Department of Insurance (CDI) Fraud Division investigation alleged that Fish and Bacino
purchased large blocks of workers' compensation client referrals from a prominent attorney television
advertising service. CDI investigators reviewed more than 100,000 financial records in tracing the
flow of money.
The investigation found that when a referral was received for a prospective workers' compensation
case, the client was sent to doctors and other health care providers that had a business relationship
with Premier. Premier would do the billing and collection work in return for a 50 percent or more fee
of what they collected. More than 16,000 patient referrals were purchased through the attorney
advertising service.
After the client had been sent to the doctors and other healthcare providers, the client would then be
sent to various workers' compensation attorneys that had a financial relationship with Fish and
Bacino.
The Los Angeles County District Attorney's Office, the Franchise Tax Board, U.S. Postal Inspection
Service and the National Insurance Crime Bureau made major contributions to the investigation.
As part of the negotiated plea, CDI received $900,000 as reimbursement for investigative costs.
In return for the lien dismissals and payment of the costs of the investigation, both suspects will be
granted felony probation. Sentencing will occur June 25, 2010 according to the Los Angeles County
District Attorney's Office.
Insurance Commissioner Poizner Announces Two San Diego
Men Plead No Contest in Workers' Compensation Fraud Cases
Duo Agree to Forgo $60 Million in Medical Liens and Bills Pending at WCAB
California Insurance Commissioner Steve Poizner today announced that David Wayne Fish, 47, of
San Diego and Birger Greg Bacino, 50, of Rancho Santa Fe, have plead no contest to felony
charges of compensation or inducement for referring clients for profit in a workers' compensation
scheme and agreed to release $60 million in medical liens and bills prior to entering their plea. They
will serve three years of probation.
Fish and Bacino are the principal owners of Premier Medical Management Systems Inc. The business
was charged with making false and fraudulent workers' compensation claims and filing false tax
returns. At its peak, Premier Medical owned and operated five clinics in the greater Los Angeles area
and contracted with more than 100 medical providers. More than
$60 million in liens and bills created by Premier Medical Management Systems Inc. were pending
before the Workers' Compensation Appeals Board (WCAB) and as part of the negotiated disposition,
Fish and Bacino agreed to drop those claims.
"Getting kickbacks for referring medical payments is illegal and drives up the costs in the system,"
Commissioner Poizner said. "Because of our work and that of the Los Angeles District Attorney's
office, we were able to prevent $60 million in fraudulent and unnecessary claims in being made. We
will continue to work hard to eliminate these unneeded costs to keep workers' compensation
insurance affordable."
A California Department of Insurance (CDI) Fraud Division investigation alleged that Fish and Bacino
purchased large blocks of workers' compensation client referrals from a prominent attorney television
advertising service. CDI investigators reviewed more than 100,000 financial records in tracing the
flow of money.
The investigation found that when a referral was received for a prospective workers' compensation
case, the client was sent to doctors and other health care providers that had a business relationship
with Premier. Premier would do the billing and collection work in return for a 50 percent or more fee
of what they collected. More than 16,000 patient referrals were purchased through the attorney
advertising service.
After the client had been sent to the doctors and other healthcare providers, the client would then be
sent to various workers' compensation attorneys that had a financial relationship with Fish and
Bacino.
The Los Angeles County District Attorney's Office, the Franchise Tax Board, U.S. Postal Inspection
Service and the National Insurance Crime Bureau made major contributions to the investigation.
As part of the negotiated plea, CDI received $900,000 as reimbursement for investigative costs.
In return for the lien dismissals and payment of the costs of the investigation, both suspects will be
granted felony probation. Sentencing will occur June 25, 2010 according to the Los Angeles County
District Attorney's Office.
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