DWC Fraud Report Released

Publish Date:Jul 05, 2017
Summary:
The Division of Workers’ Compensation (DWC) contracted with the RAND Corporation to “assess medical provider fraud in the California workers’ compensation system and propose a set of comprehensive and strategic policy recommendations.

As a follow-up to last year’s stakeholder process and legislation on provider fraud, the Division of Workers’ Compensation (DWC) contracted with the RAND Corporation to “assess medical provider fraud in the California workers’ compensation system and propose a set of comprehensive and strategic policy recommendations.”  According to the DWC, the report “describes the challenges and issues related to provider fraud in the workers’ compensation system and recommends changes to existing practices to achieve specific anti-fraud goals. Three key recommended measures include:

 

• The detection of fraudulent providers through the use of advanced analytics.

• Keeping post-employment medical treatment claims under the employer’s control.

• Suspending lien claims for suspected fraud providers.

 

The report is available here.

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