Group Charged With Insurance Fraud

A group including doctors and other health-care providers in New York was charged with defrauding insurers Wednesday in an alleged scheme that state Attorney General Andrew Cuomo said represented a "frightening mutation" of typical insurance-fraud cases.
Fraud is one of the culprits behind ballooning health-care costs and one of the challenges facing an overhaul of the health system.
According to the indictment, a personal-injury attorney allegedly paid hospital workers to give him names of patients who had recently been involved in motor-vehicle accidents. Those patients would be covered under no-fault auto-insurance laws and thus eligible for health-care services, like acupuncture and chiropractic services, to treat their accident-related injuries. The attorney then allegedly would supply the names of these patients to the owner of two medical clinics.
A 147-count indictment alleges that two men acted as "steerers" and they would persuade these patients to receive treatment at the two clinics and that they would often direct patients to exaggerate or fabricate injuries. According to state officials, the clinics would then submit auto-insurance claims for unnecessary care or care that never took place and patients would get a cut of the insurance payments.
Among the 12 people indicted were two physicians, two chiropractors and two acupuncturists. All told, the group allegedly made more than $1 million in fraudulent claims. No patients were named in the indictments Wednesday, but officials said the investigation is continuing.

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