gent in attempting to detect and resist fraudulent claims, some insurers may end their anti-fraud efforts and pass the added costs onto consumers.
ti-fraud provisions in the health care reform bill. We encourage you to continue that advocacy and support the inclusion of anti-fraud expenses in medical loss ratios.
“Departments have stepped up anti-fraud efforts and reached out to private insurers to collaborate on fighting organized medical fraud rings, it would be counterproductive to discourage anti-fraud activities.
“We would be available to meet with you and your staff to discuss this issue further.
BATON ROUGE—Two fraud bills were signed into law at the end of the 2010 Louisiana legislative session.
“Regards,
“You were an active supporter of an- Dennis Jay, Executive Director”
HB 1483 targets health care fraud by clearly differentiating health-insurance fraud from general insurance fraud. Health schemes will be considered separate crimes with separate penalties.
SB 792 extends the state’s insurance fraud programs for two more years. It also makes the anti-fraud fund a dedicated fund to prevent the money from being siphoned-off at the end of the fiscal year. Any unused money instead would be given back to insurers that had financed the fund via annual assessments.
AUSTIN—Reports out of Travis County district court note the sentencing of Bobby Phifer of Greenville, on workers’ compensation fraud-related charges. Phifer was sentenced to six months in jail.
Phifer reported a job-related injury while working as a laborer for JC2DC2 Enterprises of Austin. He claimed he was unable to work as a result of the injury, and the company WC carrier began paying income benefits to him.
It was later discovered that Phifer was working as a general laborer for multiple staffing services while receiving income benefits.
In Other Double-Dipping News Travis County grand juries indicted two claimants, in separate cases, on workers’ compensation fraud-related charges.
Thomas Mikulenka of League City and Chindra Michael of Silsbee allegedly collected $23,493 and $3,437 in benefits, respectively that they were not entitled to.
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