News Main Page
Email A Friend
November 21, 2017
Dr. Brent Pratley, Workers' Compensation Orthopedic Surgeon, Died On November 10th 2017 After A Long Illness
November 20, 2017
Del Real Father And Son Plead Guilty To Four Felony Counts Of Workers’ Compensation Fraud In Salinas, California
November 16, 2017
Norma Reyna Garner Released Of All Charges In Landmark Medical Case In Orange County
November 15, 2017
California Court of Appeal Denies Defense's Petition For Writ Of Mandate In Sim Hoffman, M.D. Workers' Compensation Fraud Case
|California's Department of Workers' Compensation Posts RAND Report on Recommendations for Fraud Prevention in the Workers’ Compensation System|
By Lonce LaMon and the California Department of Industrial Relations' Newsline - June 28, 2017
The Division of Workers’ Compensation (DWC) posted a report on recommendations to prevent fraud in the workers’ compensation system, issued by the RAND Corporation.
DIR last year requested that the RAND Corporation assess medical provider fraud in the California workers’ compensation system and propose a set of comprehensive and strategic policy recommendations. The report describes the challenges and issues related to provider fraud in the workers’ compensation system and recommends changes to existing practices to achieve specific anti-fraud goals. Three key recommended measures include:
The detection of fraudulent providers through the use of advanced analytics.
Keeping post-employment medical treatment claims under the employer’s control.
Suspending lien claims for suspected fraud providers.
Since the beginning of this year when anti-fraud bills SB 1160 and AB 1244 went into effect, more than 285,000 liens worth a combined claim value of more than $1 billion have been stayed. The liens are associated with 121 medical providers being prosecuted for fraud-related crimes. DIR has also started the process of consolidating and dismissing the liens of providers who have been suspended from the workers’ compensation system due to criminal convictions.
DIR has posted information on its fraud prevention efforts online, including information on suspended medical providers. Providers are suspended when they have been convicted of fraud-related crimes, have been suspended from the Medicare or Medicaid programs due to fraud or abuse, or have lost their professional license.
Lonce LaMon, email@example.com, journalist, and the California Department of Industrial Relations Newsline, news release of June 28th 2017, www.dir.ca.gov