Chiros fight Kentucky anti-solicitation law

Fraud fighters seek to thwart constitutional challenge

A federal court in Kentucky ruled the state’s anti-solicitation law unconstitutional last year. In response, anti-fraud community helped enact a new solicitation law this year that satisfies the court’s concerns.

The legislature overwhelmingly approved the fix.

Soliciting crash victims for potentially worthless medical treatment thus took a hit. The new law strictly limits soliciting of drivers and passengers for 30 days after the crash. It also blocks insurance payments to providers who violate the law, and protects consumers from making forbidden payments.

The law serves a timely purpose. Fraud rings are moving into Kentucky — some from Florida to escape ramped-up heat by law enforcement. They’re trying to lure often-traumatized crash victims for treatment at shady clinics that lodge inflated insurance billings for useless treatment.

Problem fixed, right? Wrong. Several chiropractors didn’t even wait for the law’s June 24 effective date.

They sued in federal court, saying the new law violates the First Amendment and due process. A hearing on an injunction to stop enforcement of the law is scheduled for late August.

Just hours before the Kentucky suit was filed, the Texas governor signed a new law restricting access to its crash reports. Much like Kentucky, the law aims to prevent insurance criminals from hounding crash victims to get injury treatment at shady clinics.

Only crash victims, their reps (insurers, medical providers, attorneys) and reporters now can obtain the full crash report. Anyone can buy the reports. Except that the personal information is redacted for outsiders, so the reports lose all value to fraudsters.

Kentucky’s new law builds on another initiative in Texas. After surviving court challenges, the state started enforcing a law restricting solicitation of auto crash victims for the first month after a crash. Fraud rings started moving out of Texas when the enforcement heat rose. They’re moving into other states like Kentucky, which the rings perceive as softer enforcement environments.

So fraud fighters must stop the Kentucky lawsuit. Success by the chiros could embolden challenges to anti-soliciting laws in other states such as Texas. 

The Coalition already has sent the Kentucky attorney general info that will help derail the suit. We also plan to team with partners to file friend-of-the-court briefs that provide strong legal support.

The new law keeping criminals from recruiting crash victims is a constitutionally sound idea that limits dishonest activity and protects crash victims from being victimized yet again.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

Summer is planning time for 2016 legislative initiatives

Must be primed for action when statehouses open

state legislationThe first half of 2015 earned us several new state fraud laws, I recently wrote in this space. Having celebrated those successes, we now should start thinking ahead to next year.

Summer is the perfect season to start that planning. Legislators already are thinking of what issues will fill up the agenda. We need to be part of that action, and ready to go as soon as statehouses open in 2016. Many sessions are short, so it’ll be a race to get our bills docketed and voices heard.

The Coalition and our partners are reviewing what bills to pursue, and in what states. Usually the bills are tagged to defined fraud problems affecting consumers and businesses in a given state.

New Jersey became the first state to make it a crime for drivers to avoid paying high auto premiums by lying that they garage and drive their vehicles in states where premiums are lower. We need to see what other states have similar problems and would be open for legislation like the New Jersey success.

The Coalition also will spend the summer crafting a model law to export to states on this issue. Of course, New Jersey offers us a good starting point.

New Mexico will be prime target for a bill allowing courts to peg a swindler’s penalty to the total dollar amount of convicted frauds. So the total of several scams against multiple insurers would fix the penalty instead of setting a smaller penalty for each scam. That bill stalled in 2015, and we think it stands a strong chance of enactment next year.

And will Michigan finally create the insurance fraud prevention authority that has percolated in the legislature for several years?

Will New York get serious about attacking no-fault schemes and criminalize recruiting for crash rings after years of stonewalling in Albany?

We’ll choose our legislative targets by talking to groups and listening to ideas.

So it’s your time to be heard: Suggest we can best help move the fraud fight forward. What state should we target, what kind of bill is needed, and what fraud problem will it take on?

Reach me at Howard@Insruancefraud.org. Your input will be very helpful as we speed into 2016.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

 

 

States marching ahead with new fraud laws in 2015

Grassroots letter-writing campaigns supported several bills

We’re almost at the halfway mark of 2015, with the summer months upon us. Most state legislatures have shuttered for the year, so this is a good time to evaluate the scorecard.

So far the tally looks pretty good. Several important anti-fraud laws have been booked, and several more are possible.

New Jersey provided a key victory. It’s now an insurance fraud for in-state drivers to deceptively register and insure their vehicles in states with lower premiums. Fraud fighters will seek to export this model to other states.

Minnesota gave the state commerce department power to lodge civil actions against fraudsters. The agency also now can kick fraudsters out of the insurance system — blocking crooks from receiving insurance payouts.  The Coalition urged both ideas a couple of years ago when the state started marching toward strengthening its anti-fraud efforts.

Kentucky limited the soliciting of crash victims for potentially worthless medical treatment. The new law fixes a court decision overturning the previous law as unconstitutional. Fraud fighters banded together to create the needed fix. Fraud rings are moving into Kentucky. They’re trying to lure often-traumatized crash victims for treatment at shady clinics that lodge inflated insurance billings for useless treatment.

Florida also confirmed that unlicensed clinics can’t make insurance claims — they’ll be charged with an insurance crime. This effort tightens clinic licensing standards.

Texas limits the use of auto crash reports by shady medical providers. The state already has made it a crime to solicit crash victims in person. Texas added teeth by restricting access to crash reports that recruiters use to identify target crash victims.

West Virginia added consumer protections against shady contractors. New Mexico and Iowa made it a crime to sell or use counterfeit airbags in vehicle repairs.

Grassroots letter-writing efforts by fraud fighters were a big factor in several states. The Coalition and IASIU jointly championed campaigns. Fraud fighters sent letters to their legislators in New Jersey, Kentucky, Minnesota and New York — urging “yes” votes on bills in their states.

More than two dozen letters were sent each in New Jersey, Kentucky and Minnesota, and a campaign record of more than 130 in New York. This likely is the first time any of these legislators has heard from constituents supporting an anti-fraud bill.

Needed no-fault fraud reforms Michigan are still in motion, while New York has crashed.

Michigan needs a state agency to add firepower against auto cons such as widespread crash rings. Yet a measure creating the agency is caught up by haggling about its larger parent bill. It’s a large package that tries to reduce spiraling medical costs of the state’s auto-insurance system.

New York once again stalled in fortifying its no-fault auto system. An auto rate evasion bill much like New Jersey’s has skidded to a halt. Also iced: clamping down on recruiting for crash rings, and using a phony credit card or bank account to pay for premiums.

We’re already looking at fraud bills to pursue for 2016 — both for Coalition work and the grassroots effort.  Let us know your thoughts.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

Dishonest drivers avoid auto premiums

Frustrated states make evasion an insurance crime

The Coalition surveyed state laws a couple of years ago to see how states deal with residents who falsely register and insure their vehicles in other states with lower auto premiums. Very few states consider this scheme an act of insurance fraud, we found.

North Carolina is an exception. Drivers must show proof of residence before they can buy auto insurance. North Carolina is trying to head off rate-evasion cons. Drivers in several states falsify North Carolina residence to obtain cheaper auto insurance than in their home states.

Rate evasion is a lose-lose for the victim state where the vehicles are garaged. Honest insurance consumers pay higher premiums to subsidize the smaller pool of drivers. Scofflaws also rob the state and local governments of registration fees or vehicle taxes.

Yet few prosecutors will go after dishonest drivers unless there’s a specific fraud law that makes convictions of violators more likely.

We may be seeing a surge of other frustrated states that have seen enough of dishonest drivers.

New Jersey is about to make life much harder for cheaters by strengthening its law targeting those who use out-of-state addresses to avoid higher New Jersey insurance. The governor signed the bill into law late last week.

New York is on tap tap with companion bills (S 4900/A 7237). The sponsors are well-placed legislators from both parties, suggesting a strong chance of success.

The Coalition is joining with insurer partners to push the legislation into law. Fraud fighters shortly will start a grassroots letter-writing campaign to show legislators in Albany why they should vote “Yes” for passage.

We strongly encourage New York fraud fighters to write their legislators. Let’s push for a surge of legislation that turns this scam into a dead-end street for cheaters.

Yet more states could see bills clamping down on premium evaders. It seems there’s a growing feeling that enough is enough. Let’s turn avoiding auto premiums into a dead-end street.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

States already inking fraud laws onto books

Partnering, grassroots letters spell success

Spring has barely started yet fraud fighters already have earned a solid slate of new state fraud laws.

Signature wins in Kentucky, New Jersey and New Mexico are on the books, with more fraud laws expected. Fraud fighters are making a clear difference in educating state lawmakers to strengthen insurance fraud laws.

Kentucky was high on our agenda after a federal court struck down the state’s anti-solicitation law. We helped launch push in early 2015 to pass a strong new law that would pass court muster.

A bill was drafted before the legislature opened. That fast start let fraud fighters open the year with a full head of steam. The governor signed the bill Monday.

It’s an insurance crime for medical mills to try and recruit crash victims for useless, inflated and potentially unsafe “medical” treatment within 30 days of the incident. It’s also illegal to encourage crash victims to file phony claims.

Crash rings are moving into Kentucky from Florida to escape ramped-up crackdowns in the Sunshine State. Stiff penalties are important to making fraudsters wish they’d stayed in Florida.

Key to passage was a joint grassroots — should we say bluegrass-roots — letter-writing campaign by the Coalition and Kentucky chapter of IASIU. The effort generated letters from fraud fighters urging their legislators to vote for the bill. That probably was the first time Kentucky legislators had heard from constituents about an anti-fraud bill.

In New Jersey, lawmakers voted to make it an insurance crime for Garden State drivers to lie about where they garage and drive their vehicles to lower their premiums. This success took several years of effort.

We now are pushing for the governor to sign the bill into law. This crime is pervasive in New Jersey. The governor’s  signature will send a strong deterrent message to drivers around the state.

Next comes New Mexico, which last week made it a specific crime to using counterfeit airbags in auto repairs. New Mexico became the seventh state to ink such a law.

Spearheading the push was a partnership between the Coalition and Honda America.

Consumer lives are in jeopardy when dishonest body shops install cheap and unsafe knockoff bags. The airbags likely won’t deploy properly in a crash, leaving drivers and passengers gravely exposed to death or serious injury.

Kentucky, New Jersey and New Mexico have gained more tools to take scammers off the streets, and deter many others.

It’s also clear that partnering is better at passing fraud laws than going it alone. The power of partnering shows that together we can place stronger anti-fraud laws onto the books, and boot more scammers off the streets.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

Let’s yank licenses of crooked docs

State license is a privilege, not a right

The Coalition has a longstanding position that medical providers who earn most of their income from insurance should have their state license yanked or suspended for committing insurance fraud. That’s a key provision of our model insurance fraud law.

A license is a privilege the state bestows, and not a right.

Why should states act so decisively? Because medical boards rarely act on their own. We surveyed medical boards several years ago and very few actively punished providers who commit insurance fraud. Some only discipline providers for violating their medicine practice, and that insurance fraud isn’t constitute such a violation.

There are enough honest docs practicing ethically that we can afford to get rid of crooks.

Medicare can now impose stiff sanctions. Docs who bilk Medicare can be kicked out of the system. They still can practice but can’t receive Medicare reimbursements. Many cheaters who specialize in fleecing Medicare thus are put out of business.

Minnesota is debating a similar move: Medical providers convicted of insurance fraud can be denied payments by the state’s auto-insurance system under a bill being considered in the statehouse.

The cheaters still can keep their medical license. They’re just out of the no-fault business. And like Medicare swindlers, the no-fault fraud specialists face potential ruin if their main source of income is shut off.

New York started booting dishonest medical providers from the state’s no-fault system several years ago. The state is showing success; more than 18 providers have been removed.

The Coalition holds up New York as a model that other no-fault states should emulate.

Crooked medical providers risk their patients’ health and wellbeing, and steal brazenly from insurers. They shouldn’t be tolerated. No-fault states should follow New York’s lead and weed out crooked docs.

The Coalition strongly believes that dishonest providers who abuse their state license to commit insurance fraud should face strict license review to determine if their license should be suspended or permanently revoked.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

Cross-state sales could open scams

Regional pacts better suited to protect consumers from con artists

The idea of allowing consumers to buy health coverage from any insurer in any state has been floated in Congress for several years. It would be an alternative to a consumer’s state or regional exchange. Someone in the Northeast thus could buy coverage from an insurer in the Southwest.

It’s a bad idea that persists. Any proposals should be voted down.

The idea would open the door for rampant fraud and undermine consumer protections. How would the system be regulated?

Let’s say a scammer in State A peddles fake health coverage to consumers in State B. Would the insurance department in State A have the resources or will to remedy those victims — non-residents who may live hundreds of miles away? That state has enough challenges just protecting its own residents.

Luckily the idea remains in the concept stage in Congress. But now it’s surfacing in state legislatures.

The Affordable Care Act lets states create regional exchanges that offer coverage to consumers within the compact. These are partnerships among like-minded states. They’re designed for closely knitted oversight that protects consumers in all states of the region.

But a well-intended New Hampshire lawmaker has introduced a bill allowing residents to buy health insurance from any other state. It would jeopardize the health and wellbeing of New Hampshire residents.

A scammer in another state could sell phony coverage to New Hampshire residents, and skirt New Hampshire’s licensing and oversight.

Who ensures out-of-state health entities are properly licensed and vetted for sale in the state? Or better, who creates and enforces regulations to prevent predators from selling across state lines?

We applaud New Hampshire’s insurance department for opposing the measure at a recent legislative hearing.

Hundreds of new state legislators took office last fall. Many barely grasp state insurance-fraud laws — and especially how they protect consumers.

These cross-border insurance proposals may seem good for the lawmaker’s state residents … at first glance. But they open the door wide for scammers. It’s the school of unintended consequences at work.

The anti-fraud community needs to educate legislators about being vigilant against fraud. That’s an important part of the Coalition’s mission. We’ll steadfastly work to make sure legislative proposals minimize unintended consequences and maximize protection of consumers throughout the nation.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

Time for pursue fraud-busting resolve for 2015

Stronger laws, better funding will move fraud fight to next level

New YearsIt’s that time again. Millions peer ahead to the new year with great expectations. That includes the anti-fraud community.

So here are several of the Coalition’s resolutions for 2015:

• We will diligently strengthen the anti-fraud effort. Getting lagging states with weak fraud laws to enact strong new ones is a big emphasis.

• We will keep up the drum beat so fraud stays a high-profile news item around the U.S. This will alert consumers to protect against being duped by shady operators, and deter fence-sitters from committing this crime.

And some resolutions we’d like others to make:

New York legislators: We finally will strengthen the state’s no-fault auto laws to lower the expensive “fraud tax” honest drivers pay in higher premiums.

New Jersey legislators: We will pass laws that chase down drivers who illicitly use out-of-state addresses to avoid paying higher New Jersey auto premiums. We also will expand the state’s immunity law to allow more sharing of case information among anti-fraud groups.

Michigan legislators: We will fulfill the aspirations of the anti-fraud community by creating an auto-fraud authority to help combat widespread no-fault scamming in the state.

Minnesota legislators: We will pass leftover anti-fraud measures that were removed from the larger fraud bill enacted in 2014.

U.S. Congress: We will properly fund the Healthcare Fraud Prevention Partnership so it can uncover health schemes that target both private and public health insurers.

The new year will be rife with promise and opportunities to move the fraud fight to the next level. Rest assured that Coalition will be front and center, helping transform that raw promise into great progress.

Happy fraud-busting New Year!

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

Michigan needs an auto-fraud authority

Push as stand-alone bill to tackle widespread staged-crash rings

Over a year ago I wrote that there’s no such thing as a “no-brainer” when it comes to passing legislation. Issues are harder to move forward when observers think they’re a “no-brainer.” I wrote that blog with Michigan in mind.

Michigan is one of the two most populous states without an infrastructure to tackle insurance fraud. There’s no fraud bureau, fraud authority or dedicated prosecutors. There’s no state agency to investigate and prosecute suspected frauds.

Several years ago the Coalition worked with anti-fraud partners to help craft a bill creating a fraud authority to target widespread auto-fraud schemes in Michigan. Staged-crash rings were among the offenders needing stifling.

The authority would have a statewide board funded by an assessment on auto insurers. The funds would be distributed as grants to law enforcement statewide, local prosecutors and others to chase down auto scammers. Michigan’s legislation was modeled after the Pennsylvania Insurance Fraud Authority, which is a successful statewide anti-fraud effort.

In advocating legislation for a fraud authority, legislators had difficulty understanding that auto insurance fraud is a statewide concern instead of a local issue. Then the state police pushed back, fearing they might lose funding for their own auto-theft authority. Those concerns eventually were resolved.

The fraud authority was a stand-alone bill. But that changed a couple of years ago when the governor, many legislators, opinion leaders and insurers decided Michigan’s entire no-fault auto insurance system needed an overhaul. So the fraud authority was rolled into the current comprehensive no-fault reform package. That has tied up efforts to pass an auto-fraud authority.

Several versions of large scale no-fault reform have fizzled, and the auto fraud authority went down with the doomed bills each time.

Michigan’s statehouse is about to close for the year, with a new legislature and leadership coming in 2015.

It’s time to rethink the issue. The auto-fraud authority should stay free of large reform bills, which often collapse from their own weight and complexity. The agency should be introduced as a stand-alone bill. It has wide support, and stands a far better chance of passing that way. Michigan drivers and fraud fighters deserve nothing less.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.

No-fault repeal could harm lower-income drivers

Quashing system could delay medical treatment for injuries

The no-fault PIP auto insurance system was created in the 1970s with noble intentions: Resolving crash claims in a timely manner, regardless of who’s at fault. The concept still works to a degree. But the unintended consequence has been the large growth of fraud schemes.

Few policymakers thought PIP would become a cash cow for scammers when the system was enacted in Florida, New York, Michigan and other states. But adaptive fraudsters quickly learned the loopholes to exploit the system to steal hundreds of millions of insurance dollars or more in false crash-related claims.

Florida, New York and Michigan have tried to reform PIP and strengthen the anti-fraud provisions in the last few years. Policymakers in those states believe no-fault still is viable. Yet there are rumblings in Florida about repealing PIP and installing a system similar to Colorado’s after that state repealed no-fault in 2004. Rampant no-fault fraud is the main factor driving calls for repeal in Florida, most recently by the editorial writers of the Palm Beach Post.

Who does repeal benefit and harm the most?

PIP clearly helps low-income drivers, especially those who cannot afford private health insurance. Their auto crash injuries are quickly taken care of under PIP. What would happen if PIP is repealed?

One of the intents of the Affordable Care Act is to expand the availability of health insurance to all — especially low-income Americans. Much of this would be achieved by expanding Medicaid eligibility, which lets states insure more poor residents.

But not every state expanded Medicaid, including Florida. Without expansion, no-fault repeal could leave the working poor — those not eligible for existing Medicaid coverage — with few options for affordable medical treatment. Yes, they would be compensated for their injuries if the other driver is at fault, but in situations where fault may be in question, the wait can be long, causing lapses in treating injuries.

The Coalition has no position on whether states should repeal PIP. But policymakers considering such a tumultuous change, especially in Florida, first should remember why their state enacted no-fault in the first place. Without no-fault, they also may have figure out how assist more lower-income residents.

If expanding Medicaid is the tradeoff for dumping no-fault, then perhaps those who advocate repeal ought to lobby the governor in Florida to expand Medicaid.

About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.