Insurance Fraud NEWS
TX health care provider sentenced for workers' compensation fraud
June 22, 2018, Rancho Viejo, TX
A Rancho Viejo health care worker has been sentenced for falsifying worker's compensation claims.
A Travis County District Court sentenced Marcus Ricoy to three years' deferred adjudication and ordered him to pay $10,000 in restitution.
Ricoy performed functional capacity evaluations -- medical exams that determine if an injured employee is physically able to perform their job duties after a work-related injury or illness. Ricoy submitted false medical claims to an insurer for more time than the services actually took to perform.
“The laws and rules are here to protect injured employees and policyholders. It's important to uncover these schemes so that we can keep a balanced system that's fair to everyone,” said Tim Riley, the Division's deputy commissioner of Compliance and Investigations.
The case was prosecuted by the Texas Department of Insurance, Division of Workers' Compensation's prosecution unit embedded in the Travis County District Attorney's Office.