Twittering away to prevent fraud

Iranian dissidents aren’t the only twitterers seeking justice these days. The city of Chandler, Arizona on Friday sent a message to local residents via Twitter to warn about a scam artist trying to stage a pedestrian accident in a city parking lot.

twitterA city employee sent out the warning after viewing video footage of the alleged scam from a security camera. The suspect seems to clearly wait for a car to back up and hit her, and then as the car goes forward to pull into a parking space, she maneuvers in front of the car to try again.
staged accident

After making what appears to be a call on her cell phone — and a full two and a half minutes later — she falls to the ground. The other oddity is that a women she was with (perhaps a convenient witness?) doesn’t come to her aid until three minutes after the car brushed her.

The driver of the car is unconcerned and walks away calmly.

Passerbys who witness the scene apparently aren’t convinced she’s injured either because they stroll by like nothing’s happened.

She stays on the ground for three minutes and then gets up when police and an ambulance show up. The women was taken away and filed a police report, which should be available later today. Stay tuned to see if any charges are levied against her.

Kudos to the folks in Chandler for posting the warning and for uploading the video. If more cities took such initiatives, fewer people would chance committing these scams that not only raise everyone’s insurance rates but also make it more difficult for real victims to get the help they need.

Anti-fraud proposals advance on Capitol Hill

capitolWatching the “sausage making” in the Senate health committee this week was both entertaining and inspiring. It was interesting to see the posturing as the committee made decisions about health care fraud — Republicans trying to limit anti-fraud provisions to government programs; Democrats wanting to extend them to private insurers.

I cringed at some of the uninformed comments that were made by senators, but with all the issues they deal with, I guess that should be expected.

Still, it was great to hear the acknowledgement from key senators that health care fraud affects both federal programs and private insurers. That’s been a mantra that the coalition, NICB and others have echoed in recent weeks in meetings on Capitol Hill. As a result of those efforts, the anti-fraud provisions in the Senate bill survived its first hurdle.

This is a major advancement in developing more public/private partnerships to combat medical fraud. The senate bill contains three important elements for the fraud-fighting community:

(1) Creates a permanent structure in the federal government to coordinate anti-fraud activities within the government and with states and private insurers;

(2) Promotes the idea of greater information sharing among all fraud fighters, public and private;

(3) And lastly, gives states more powers to crack down on bogus health insurers who claim they are exempt from regulation because of the federal Erisa act.

The legislation is potentially a breakthrough for both health insurers and property/casualty carriers in their campaign to deter, detect and investigate fraud by medical providers. This is but a first step, albeit an important one.

P.S.A. letter that the Coalition, NICB and the National Health Care Anti-Fraud Association sent to the committee in support of the bill was referenced during yesterday’s hearing. C-SPAN carried a video of it.

Solid appointment by the FBI

fbiIt’s nice to see a familiar name advance at the FBI. The agency announced today that Kevin Perkins will be the new head of the criminal investigations division. Kevin has more than 20 years of experience in combating white-collar crime and formerly managed the insurance fraud program in the days when that area was just starting to ramp up.

His history in the fraud area — combined with renewed efforts by federal law enforcement for more public/private cooperation — gives us hope that greater priority will be given to fraud cases.

We wish him continued success with his new assignment.

Republicans offer their own health care plan

gopCongressional GOPers today unveiled a list of some 25 elements of an alternative plan to reform health care. No details are available yet, but included in the list is this gem:

Allow states, small businesses and other organizations and associations to increase their purchasing power by banding together and offering health insurance at lower costs.

Sounds like the association health plan proposal that was rejected a few years back. Such a plan calls for loose regulation that would draw bogus operators out of the woodwork and result in large-scale fraud schemes against small businesses. That was the conclusion of state regulators and the coalition. You can read more about it here.

Billion here, billion there . . .

obamaIn a speech before the AMA this afternoon, President Obama said this:

“… we can save about one billion more by rooting out waste, abuse, and fraud throughout our health care system so that no one is charging more for a service than it’s worth or charging a dime for a service they did not provide.”

I don’t deal in waste or abuse, but if the White House is planning to wring out only $1 billion in fraud, I say go back and try harder.

Health care fraud is estimated at between $48 billion and $200 billion each year. A billion hardly is breaking a sweat. The White House and Congress need to get serious and build a comprehensive program to deter, detect and prosecute health care fraud so that at least 20 percent is saved, not two percent.