The FBI and U.S. Department of Justice seem to be going to great lengths recently to tout their successes in combating insurance fraud.
In recent days, both the FBI and Justice Department have issued news releases citing results and claiming that economic crime and health care fraud remain a priority for the federal government. U.S. Attorney General Michael Mukasey even gave a speech yesterday to highlight the importance for the Justice Department to fight health care fraud aggressively.
Mukasey had a lot of good things to say in his speech. I especially like this:
“We cannot prosecute our way out of this problem. For every crooked durable medical equipment company we bust, there is another one to replace it before the ink on the indictment is dry. For every wayward provider we charge, there are others willing to engage in the same frauds. The money, and the temptation, are simply too big.
That’s why the deterrent effect is such an important part of your cases. These are highly deterrable offenses, and those who might otherwise be tempted to commit them do not want to do time . . . we must learn lessons from these prosecutions that will help us to devise ways of preventing a recurrence of these frauds. That is one reason why the cooperative efforts of agencies such as the Department of Health and Human Services are vital to our long-term success.”
Too bad he also didn’t promote cooperation with private insurers.
The speech and both news releases issued cited recent numbers of arrests, cases and recoveries, but mostly fail to provide year-to-year comparisons. A peak inside the FBI’s website reveals why the agency doesn’t wish to highlight year-to-year trends. Health care fraud cases are flat, at best, and insurance fraud cases have declined in each of the last four years.
After 9/11, more than 2,400 FBI agents were re-assigned to terrorism, and today the white-collar crimes units are still some 1,700 agents below pre-9/11 levels. And it doesn’t look like that is going to improve anytime soon, according to this recent article:
“Despite a powerful surge in bank robbery, mortgage fraud and white-collar crimes, the Bush administration’s 2009 budget leaves an already handicapped FBI criminal program without the agents it needs to respond — a shortcoming acknowledged by top FBI officials.”
The federal government plays an important role in not only investigating and prosecuting fraud, but also in helping to send a strong message that aggressively fighting fraud is important for government agencies, insurers and society in general. Weakening those efforts hurts us all.

Financial auditors in state insurance departments are the unheralded workers who help ensure that insurance companies remain solvent and that insurance agencies stay honest. The
Update – May 21, 2008 – A body was recovered yesterday by police. Howell appeared in court, but few details were provided. The North Carolina Department of Insurance released this statement:
The fraud-fighting community lost a good member last Friday with the passing of Jerry Zappola. An SIU manager, Jerry had a great passion for combating fraud and for helping others.
I’ve never subscribed to the simplistic idea that people commit insurance fraud just to “get back” at their insurer for charging high premiums, denying an earlier claim, or some other unpopular decision.
The coalition has been critical of state medical boards for failing to take action against providers who commit fraud. Our 1998