Physical Therapist and Son Charged with Insurance Fraud

San Francisco Bay Area pair also charged with grand theft and practicing medicine without a license

A licensed physical therapist and her son, who holds no license, have been charged with felonies after allegedly receiving $4.5 million from insurance companies for false claims.

Paula Skinner, of Glen Ellen, and her son Matthew Skinner, of Pleasanton, have each been charged with 34 felony counts related to crimes that allegedly occurred at their South San Francisco businesses, Pacific Occupational Health Clinic and Action Therapeutics.

The pair will appear in San Mateo County Superior Court on September 29, 2017, to set a date for their upcoming preliminary hearing.

The Skinners have each been charged with 10 counts of preparing and filing false insurance claims, 10 counts of conspiring to make fraudulent insurance claims, 10 counts of grand theft, and four counts of practicing medicine without a license. Most of the charges include enhancements because the crimes were aggravated white collar crimes with excessive losses.

The criminal complaint filed by the San Mateo County District Attorney’s Office alleges that between 2010 and 2017 the Skinners committed crimes against Liberty Mutual, Traveler’s Insurance, Hartford Insurance, State Compensation Insurance Fund (SCIF) and Intercare Insurance.

Since their arrests, more insurance carriers have come forward to report additional losses. It is alleged that the Skinners billed over $15 million and received payments of over $4.5 million.

The investigation found that the Skinners co-owned and operated Pacific Occupational Health Clinic as a medical corporation. Medical corporations must be majority-owned by physicians and laypersons cannot have any ownership.

The Skinners allegedly hired physicians to act as the medical directors of Pacific Occupational Health Clinic, but the Skinners continued to run the business, including hiring and firing the medical staff and making medical decisions for patients. Pacific Occupational Health Clinic specialized in treating injured workers and billing worker’s compensation health plans.

The Skinners also allegedly referred patients to their other business, Action Therapeutics, for unnecessary physical therapy and chiropractic care.

The charges are the result of an investigation conducted by the San Mateo County District Attorney’s Office, with assistance from the Department of Consumer Affairs’ Division of Investigation (DOI), and the FBI.  Investigators from DOI’s Investigation and Enforcement Unit, DOI’s Enforcement Support Unit, DOI’s Health Quality Investigation Unit and Operation Safe Medicine worked with San Mateo County District Attorney inspectors over the course of several months.

Paula Skinner’s physical therapy license is currently inactive. The Physical Therapy Board of California is reviewing the case and will take disciplinary action against her license as appropriate.

Any insurance company that believes it was a victim of the Skinners is asked to contact San Mateo County District Attorney Inspector Steve Sysum at (650) 877-5446.