Pennsylvania Insurance Fraud Prevention Authority

Multi-state partnership snags healthcare insurance fraudsters with jail time and mega-fines.

https://www.discoverhumboldt.com//sgi-s-top-5-insurance-fr

LIGHTS. CAMERA. FRAUD. We’re near the finish line for two new TV spots that help consumers understand how serious a crime insurance fraud is.

What's way worse than having a root canal? Being found guilty of falsely charging for "conducting 800 root canals." This cleaning ultimately amounts to six years in prison and over $400,000 in restitution to be paid.

What's way worse than having a root canal? Being found guilty of falsely charging for "conducting 800 root canals." This cleaning ultimately amounts to six years in prison and over $400,000 in restitution to be paid.

Ramp up well underway.

Insider wasn't the "insider" she thought she was.

Three years and three million in restitution, or nine years? Only two options on this restaurant owner's menu from a recent worker's comp fraud conviction.

Guilty as charged. A Bethlehem, PA chiropractor pleads guilty to fraudulently submitting $236,000 in health insurance claims for patients he didn’t see ... and days he didn’t even work!

Beating the system to get a fraudulent benefit payout from an insurer can be tempting to many, especially during tough times like during a pandemic. However, a recent Coalition Against Insurance Fraud blog informs consumers why the high risk isn’t worth the low reward.

ALERT: PA insurance commissioner warns PA insurers that some doctors/dentists have been sending patients inappropriately high COVID-19-related bills including these top two scenarios: 1) dentists imposing extra charges for masks and other PPE/supplies, and 2) laboratories or other testing companies charging very high prices for tests for the virus that causes COVID-19.

A Lancaster, PA psychiatrist has been charged with insurance fraud, among many other felony violations, for allegedly writing controlled substance prescriptions without seeing or monitoring patients ... and then billing Medicaid and other insurers for office visits that did not occur!

Case update: Arson and insurance fraud charges lodged earlier this year against owners of a Susquehanna-based newspaper were bound over for trial following a preliminary hearing in New Milford District Court. The couple is accused of setting fire to the newspaper office and an apartment building they owned on Sept. 2, 2019. Learn more here: https://bit.ly/2YbZLqU

Don’t do the crime, if you can’t do the time ... A Doylestown man gets 37-months in prison term for his role in a massive health insurance fraud scheme - which involved fraudulently buying (and paying for) premium policies for alleged patients of a substance abuse treatment center and then overbilling insurers by $17M+ between 2015-2018.

[FREE webinar] Tom Donahue, IFPA Executive Director, will take part in a virtual panel discussion regarding the impact of COVID-19 on liability claims. Register now to join him and other industry experts on Thursday, May 28 at 12 p.m. (EST).

Double-duty fraud | A Cambria Co. man fraudulently claimed a hit-and-run accident with his auto insurer by posing as a police officer to obtain video of the Walmart parking lot he said it occurred in. The real police discovered his plot and he’s now facing multiple charges, including insurance fraud.

Robo-wrong number ... A health plan scammer accidentally calls the COO of the insurance company they were fraudulently claiming to be from whoops! Listen to what they said here:

Slowing the spread of scams ... The FCC is taking forceful action against robocaller scams by ending the practice of formally warning before fining, including recently issuing a $82M fine to a NC-based health insurance telemarketer and pushing gateway providers to end COVID-19-related calls all of which stopped their calls within 24 hours.