Friday, July 1, 2016
Defrauding Insurance Company Did Not Warrant Lifting Medical License—C.A.
By a MetNews Staff Writer
Receipt of disability insurance payments by a doctor through fraud was insufficient to warrant yanking his medical license, given that no patient was harmed, the Court of Appeal for this district has ruled.
The decision came in an unpublished opinion Wednesday by Presiding Justice Frances Rothschild of Div. One. It overturns a decision by Los Angeles Superior Court Judge James Chalfant who denied a writ of administrative mandamus sought by Dr. Amir Pirouzian.
Div. One granted a peremptory writ in the first instance.
Pirouzian, an ophthalmologist at Children’s Specialists of San Diego (“CSSD”), had gone on medical leave. While on leave, and while claiming he was totally disabled, he went to work fulltime for Kaiser Permanente Santa Clara Medical Hospital, receiving from an insurance company approximately $10,700 in disability payments to which he was not entitled.
The doctor was charged with two felony counts based on defrauding the insurance company, as well as one count of resisting arrest, a misdemeanor. Under a plea bargain, the felony charges were dropped, he pled guilty to the misdemeanor, was placed on two months of probation, and the conviction was later expunged.
The Div. One opinion directs that Chalfant scrap his order denying relief and grant a writ of administrative mandamus. Rothschild explained:
“Dr. Pirouzian’s dishonest acts, while serious, were focused on his efforts to obtain disability insurance benefits and preserve the possibility of returning to work at CSSD. Significantly, there is no evidence that his dishonesty involved or affected the treatment or care of any patient, or the billing of clients.”
She went on to say:
“There is nothing in the record to suggest that Dr. Pirouzian would repeat his dishonest conduct or to indicate that he is now a danger to the public.
“Without diminishing the seriousness of Dr. Pirouzian’s conduct, our review of the entire record, in light of the applicable criteria and legislative priorities, compels the conclusion that outright revocation of Dr. Pirouzian’s license was unnecessary to protect the public and contrary to the goal of making him ‘a better physician.’…The discipline was excessive and, therefore, an abuse of discretion.”
The case is Pirouzian v. Superior Court, B266015.
Irvine appellate specialist William J. Kopeny represented Pirouzian. Deputy Attorneys General Thomas S. Lazar and Martin W. Hagan acted for the real party in interest, the Medical Board of California.
Copyright 2016, Metropolitan News Company