For most of his career, Tom Fraysse has represented victims of fraudulent practices and schemes in common law fraud, unfair business practices, California Insurance Code section 1871.7 (“qui tam”), state and federal False Claim Act, and civil RICO cases against a wide spectrum of defendants – corporations, LLCs, officers, directors, doctors, lawyers, hospitals, clinics, health management organizations, chiropractors, medical device manufacturers, medical device distributors, pharmacists, pharmaceutical companies, automotive repair shops and professional athletes, among others. He files lawsuits for insurance companies against defendants for making false, fraudulent or misleading insurance claims that are prohibited by California Penal Code sections 549 and 550 (California’s criminal insurance fraud statutes) and California’s insurance qui tam statute (California Insurance Code section 1871.7); for engaging in prohibited self-referral of patients to entities in which a doctor has a financial interest; for paying monetary kickbacks in exchange for the referral of clients or patients; for violating the Moscone-Knox Professional Corporation Act (California Corporations Code section 13400 et seq.), including participating in schemes in which unlicensed lay persons own, operate and control “sham” law offices or medical corporations; for billing for health care treatment or services that were not rendered; for the illegal and improper use of Current Procedural Terminology (CPT) codes on billing statements and CMS-1500 forms, including up-coding and unbundling; for falsifying medical records as part of a fraud scheme; for providing unnecessary medical services or diagnostic procedures; and for employing cappers, runners or steerers to secure patients, among other prohibited practices. Mr. Fraysse and the Knox Ricksen LLP health care fraud group have secured a string of large judgments under California’s insurance qui tam or “whistleblower” statute (California Insurance Code Section 1871.7), including a $11,544,037 judgment and a permanent injunction in the matter of People of the State of California ex rel. Allstate Insurance Company v. Wonguen Chang et al. (Los Angeles County Superior Court , Case No. BC541476), which involved claims made by a phony or “sham” law firm owned and operated by non-professionals, and a $7,010,668.40 judgment in the matter of People of the State of California ex rel. Allstate Insurance Company v. Daniel H. Dahan and Progressive Diagnostic Imaging, Inc. (Los Angeles County Superior Court, Case No. BC-397695 and 3 Cal.App.5th 372; 207 Cal.Rptr.3d 569), which arose out of the production of false, fraudulent or misleading x-ray reports to support fraudulent claims against insurance companies. In addition to the string of judgments, Mr. Fraysse and the Knox Ricksen LLP health care fraud group have obtained permanent injunctions to prevent the resumption of fraudulent activities and to protect the public. Over his 35 year career, he has tried in excess of 30 jury trials to verdict, most of which involved fraud.
Mr. Fraysse has been recognized by his peers as a Northern California Super Lawyer from 2005 to the present, holds an AV rating (“Preeminent”) from Martindale Hubbell – “a testament to the fact that a lawyer’s peers rank him or her at the highest level of professional excellence,” and was elected to and is an Associate with the American Board of Trial Advocates. He hold a bachelor’s degree from UC Berkeley and a JD from University of the Pacific McGeorge School of Law. He practices in both the Walnut Creek and Los Angeles offices of Knox Ricksen LLP and serves as the firm’s Managing Partner. Mr. Fraysse is the current President of the Anti-Fraud Alliance.