Pirouzian v. Super. Ct.

CourtCalifornia Court of Appeal
DecidedJuly 11, 2016
DocketB266015
StatusPublished

This text of Pirouzian v. Super. Ct. (Pirouzian v. Super. Ct.) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pirouzian v. Super. Ct., (Cal. Ct. App. 2016).

Opinion

Filed 6/29/16 Certified for Publication 7/11/16 (order attached)

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION ONE

AMIR PIROUZIAN, B266015

Petitioner, (Los Angeles County Super. Ct. No. BS148788) v. OPINION AND ORDER THE SUPERIOR COURT OF GRANTING PEREMPTORY LOS ANGELES COUNTY, WRIT OF MANDATE

Respondent;

MEDICAL BOARD OF CALIFORNIA,

Real Party in Interest.

ORIGINAL PROCEEDING; petition for writ of mandate. James C. Chalfant, Judge. Petition granted. Law Offices of William J. Kopeny and William J. Kopeny for Petitioner. Kamala D. Harris, Attorney General, Gloria L. Castro, Assistant Attorney General, Thomas S. Lazar and Martin W. Hagan, Deputy Attorneys General, for Real Party in Interest. No appearance for Respondent. The Medical Board of California (the Board) revoked Amir Pirouzian, M.D.‟s medical license. Dr. Pirouzian filed a petition in the superior court for a writ of administrative mandamus to set aside the Board‟s decision, which the trial court denied. Dr. Pirouzian then filed a petition for writ of mandate in this court. We requested opposition and notified the parties of our intention to issue a peremptory writ. (See Palma v. U.S. Industrial Fasteners, Inc. (1984) 36 Cal.3d 171, 180 (Palma).) We now grant the petition. FACTUAL AND PROCEDURAL BACKGROUND The Board granted a medical license to Dr. Pirouzian in 1996. Before the actions that gave rise to this proceeding, Dr. Pirouzian had no record of disciplinary action against him. It is undisputed that he is, as the administrative law judgment (ALJ) found, “a highly skilled, competent physician and surgeon who has never been found responsible for causing any patient harm.” In 2006, Dr. Pirouzian began working as a pediatric ophthalmologist at Children‟s Specialists of San Diego (CSSD). CSSD provided him with a group disability insurance plan from Northwestern Mutual. Dr. Pirouzian purchased additional disability insurance from the same insurer. On August 1, 2006, Dr. Pirouzian took a medical leave of absence from CSSD due to depression. A psychiatrist, Dr. Brett Johnson, diagnosed Dr. Pirouzian as suffering from a recurring “major depressive disorder,” and certified him as being totally and temporarily disabled. While on leave, Dr. Pirouzian submitted claims for and received disability insurance benefits from Northwestern Mutual. In October 2006, Dr. Johnson released Dr. Pirouzian to return to CSSD on a part-time basis, and Northwestern Mutual reduced his disability payments. In late December 2006, Dr. Pirouzian applied for full-time employment with Kaiser Permanente Santa Clara Medical Hospital (Kaiser). He accepted an offer for the position in May 2007 and began working at Kaiser as an ophthalmologist in July. At the same time, CSSD placed Dr. Pirouzian on unpaid medical leave. Meanwhile, he failed to

2 disclose to Dr. Johnson, CSSD, or Northwestern Mutual that he had applied for, and accepted, the position at Kaiser. For approximately three months—from July 2007 to October 2007—Dr. Pirouzian made a series of affirmative misrepresentations regarding his employment status to Dr. Johnson, CSSD, Northwestern Mutual, and the California Employment Development Department (EDD). Specifically: (1) he failed to tell Dr. Johnson or CSSD that he had accepted the position with Kaiser; (2) two weeks after Dr. Pirouzian began working at Kaiser, he falsely told a Northwestern Mutual benefits specialist that he was not working, and repeated this falsehood in a letter to Northwestern Mutual the next day; (3) approximately one week later, Dr. Pirouzian spoke by telephone with another Northwestern Mutual benefits specialist and falsely told her that he had been visiting family in Iran in July and would be spending more time with them in August; (4) in a written financial statement that called for information about Dr. Pirouzian‟s salary for each of his employers, he identified CSSD as his employer (from whom he received no income), and did not disclose his employment with Kaiser; (5) in early September, Dr. Pirouzian signed an EDD form stating that he had worked “0” hours from July 30 to August 12, had no earnings, and was unable to work as a result of a disability; and (6) in late September, Dr. Pirouzian falsely told a Northwestern Mutual benefits specialist that he was in Europe. As a result of Dr. Pirouzian‟s misrepresentations and the concealment of his employment with Kaiser, Northwestern Mutual continued to pay disability benefits to him. Northwestern Mutual discovered the misrepresentations in October 2007 and cancelled Dr. Pirouzian‟s insurance. He had received approximately $10,700 in disability payments that should not have been paid.1 During an investigation by the Department of

1 In his petition, Dr. Pirouzian stated that the “actual amount” he received was approximately $8,600, and indicated that references to larger amounts are due to interest on that amount. Dr. Pirouzian did not provide any record citations to support this information. The court‟s order denying Dr. Pirouzian‟s petition stated on page four that Dr. Pirouzian “received a total of approximately $10,000 in disability payments to which

3 Insurance, Dr. Pirouzian said that he had repaid some of the disability payments and was willing to pay the remaining sum. In June 2011, Dr. Pirouzian left Kaiser and, the following month, began a research fellowship with Gavin Herbert Eye Institute at the University of California, Irvine. In November 2011, the San Diego County District Attorney charged Dr. Pirouzian with two counts of insurance fraud. (Pen. Code, § 550, subds. (a)(1) & (b)(1).2 A third count was later added: willfully delaying a public officer in the discharge of official duties, a misdemeanor, under Penal Code section 148, subdivision (a)(1).3 After the criminal complaint was filed, Dr. Pirouzian paid Northwestern Mutual $10,700. As part of a plea agreement, Dr. Pirouzian pled guilty to the misdemeanor count and the District Attorney dismissed the insurance fraud counts. Dr. Pirouzian agreed to pay $5,000 in restitution to the Department of Insurance. The plea agreement and the court‟s minutes indicated that full restitution had been paid to Northwestern Mutual. The trial court placed Dr. Pirouzian on three years probation, which was later reduced to 60 days. The court subsequently expunged the conviction.

he was not entitled,” and on page nine that Dr. Pirouzian “received $18,633 in overpayments.” The court‟s order did not cite to the record as to the latter fact. 2 Subdivision (a) of Penal Code section 550 provides: “It is unlawful to do any of the following, or to aid, abet, solicit, or conspire with any person to do any of the following: [¶] (1) Knowingly present or cause to be presented any false or fraudulent claim for the payment of a loss or injury, including payment of a loss or injury under a contract of insurance.” Subdivision (b) of Penal Code section 550 provides: “It is unlawful to do, or to knowingly assist or conspire with any person to do, any of the following: [¶] (1) Present or cause to be presented any written or oral statement as part of, or in support of or opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing that the statement contains any false or misleading information concerning any material fact.” 3 Subdivision (a)(1) of Penal Code section 148 provides in pertinent part: “Every person who willfully resists, delays, or obstructs any public officer, peace officer . . . in the discharge or attempt to discharge any duty of his or her office or employment, when no other punishment is prescribed, shall be punished by a fine not exceeding one thousand dollars ($1,000), or by imprisonment in a county jail not to exceed one year, or by both that fine and imprisonment.”

4 Dr.

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