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Appeals court declines to reopen criminal comp fraud case


A California appeals court on Wednesday declined to revisit the case of a woman prosecuted for workers compensation fraud, ruling that reopening the matter would prejudice the defendant.

The California Court of Appeals denied state prosecutors’ appeal of a trial judge’s decision allowing a lesser charge in a criminal case against Evelyn Rivera, who was charged in 2018 with two felony insurance fraud counts for filing a false comp claim.

The trial court reduced the two felonies to misdemeanors when Ms. Rivera agreed to pay $20,000 in restitution, perform 20 hours of community service and attend a life skills class.

Prosecutors challenged the court’s jurisdiction to reduce the Insurance Code felony count. Ms. Rivera sought to set aside that count on the grounds the alleged conduct must be charged under a more specific health care fraud provision.

The trial court agreed and ordered the felony reduced to a misdemeanor after Ms. Rivera paid restitution.

The appeals court denied the state’s petition because “the need for review does not outweigh the risk of harassment of the accused.”

The court found Ms. Rivera correctly argued the state should have prosecuted her under the more specific health care fraud provision, and it dismissed the remainder of the state’s appeal as moot.  

 

 



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