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Copay Investigation Led To Recovery Of $9 Million

05 Mar, 2009 WorkersCompensation.com

                               
New York, NY (CompNewsNetwork) - An investigation of inflated billings by medical providers was instrumental in the recovery of $9 million for New York State taxpayers while other health care-related investigations led to 171 arrests, the New York State Insurance Department said in a report released March 1.

The 2008 Annual Report on Health Insurance Fraud issued by the Insurance Department's Frauds Bureau lists the recovery of the $9 million as among the significant cases investigated by the Bureau last year.

The money was recovered from five medical providers. The providers submitted inflated claims to the New York State Health Insurance Program for treating state and local government employees. The medical providers also paid fines totaling $78,551.

Other highlights of the report stated:

Eleven people, including three doctors, a chiropractor, two acupuncturists, employees of a medical clinic and 10 corporations were charged with operating a medical mill that cheated insurers of $6.2 million by filing false medical insurance claims after staging auto accidents.

Sixty-two people and two businesses were indicted on charges they participated in another staged accident ring that defrauded insurers of $1.6 million after purposefully causing 40 traffic accidents and then filing phony insurance claims.

There were 14,142 reports of suspected health care fraud received by the Frauds Bureau in 2008, including 1,421 involving accident and health insurance, 382 involving disability insurance and 12,339 involving no-fault insurance.

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