California Orthopedic Doctor Charged With State Insurance Fraud for Allegedly Providing Unnecessary and Excessive Medical Treatment for Ortho Patients

California county district attorney offices continue to prosecute health care providers for insurance fraud and workers' compensation insurance fraud. They are also using Indictments more often to put more pressure on the defense as a recent case demonstrates.

On May 30, 2018, a San Joaquin County criminal grand jury indicted Dr. Gary Royce Wisner on 11 felony counts of insurance fraud for allegedly defrauding insurers of more than $700,000 for providing unnecessary and excessive medical treatment including x-rays for orthopedic patients.  Dr. Wisner will be arraigned on June 26, 2018 in San Joaquin County Superior Court.  

The case may have overlapped with a Medi-Cal complaint or allegation since in May 2017 the Bureau of Medi-Cal Fraud and Elder Abuse executed a search warrant and seized documents. The investigation was multi-agency and also included the California Department of Insurance and the U.S. Department of Health and Human Services.


The prosecution contends that the four insurer "victimes" include State Compensation Insurance Fund, Zenith Insurance, Hartford and Tristar, the federal insurance system. Thus, this ultimately appears to be primarily a workers' compensation fraud case. The San Joaquin County District Attorney's Office is prosecuting this case.

A search warrant is the time for anyone to hire counsel and begin mounting a defense to any case. A case such as this is no different. The May 2017 search warrant in this was was an important sign that a criminal investigation is ongoing. However, there were no charges for Medi-Cal fraud. This may signal that the search warrant should be challenged.

An Indictment also makes the case more challenging in state court and requires a different set of motions to challenge the evidence and testimony. An Indictment means that the witnesses have already testified at the grand jury and the transcripts will provide a road map to the government's case. District Attorneys' Office are indicting fraud cases more often now in order to deny defendants the ability to cross-examine witnesses at preliminary hearings or to present exculpatory evidence.