NICB Reports on Mid-Year Status Update on Anti-Fraud Measures

By Denise Johnson | July 29, 2014

New anti-fraud legislation was passed this year in Colorado, Georgia and Minnesota, according to Tim Lynch, government affairs director at the National Insurance Crime Bureau.

Lynch discussed the status of anti-fraud legislation and other NICB efforts during a recent podcast interview with Claims Journal.

At the federal level, Lynch said that the NICB is on the executive committee of the National Healthcare Fraud Prevention Partnership. He described it as a collaboration of representation from the U.S. Department of Health and Human Services, the Department of Justice, as well as other federal agencies and anti-fraud organizations that came together as a result of the Affordable Care Act.

Lynch said that as more people purchase health insurance, there is the likelihood of increased fraud.

Because fraud impacts not only property/casualty insurance but also healthcare insurance as well as Medicare and Medicaid there is the likelihood of crossover, Lynch said.

“Given all of the potential for crossover amongst those groups, and there is a lot of crossover with organized crime taking place that’s, quite frankly, trying to rip off all of those different entities at once. We were one of many groups that got together to say we should probably look at, and get together, and share information across groups, and across agencies on what we might do to combat that fraud once Obamacare’s enacted,” he said.

According to Lynch, the partnership has been the NICB’s primary mission at the federal level for the past few years.

At the state level, the NICB tries to focus on a few key states on an annual basis.

“Over this past year, we were involved in Colorado, in some vehicle titling legislation to protect consumers in Colorado from potential vehicle fraud,” said Lynch.

Besides Colorado, Lynch said the NICB was involved in groundbreaking legislation in the state of Georgia to help its citizens against malicious and overzealous solicitation of accident victims.

Another state where the NICB concentrated its efforts this year was Minnesota.

“We were involved in a very comprehensive anti fraud effort in the state of Minnesota. One of the things that we picked up on at NICB through our collection of questionable claims derived from our members is that these organized criminal rings, if you will, migrate to states that they perceive to have what we call a less aggressive fraud environment,” Lynch said.

According to the government affairs director, Minnesota lags behind some other states when it comes to fighting insurance fraud. As a result, he said organized criminal rings have chosen to set up shop in the state having moved from states like Florida.

The organization was successful in getting a permanent standing committee in Minnesota on insurance reform with insurance fraud as the committee’s primary topic.

“Minnesota will, frankly, I think, be the only state that will have a state legislative committee solely devoted to insurance reform and insurance fraud topics. We’re proud of that effort,” said Lynch.

The NICB engaged in an aggressive public affairs campaign in Minnesota that involved social media, rural radio and grassroots advocacy, he said.

“One of the things we need to do as an industry, quite frankly as a society, is make sure that people know that insurance fraud hits them in the pocketbook to the tune of $30 billion per year. We’re all paying for that through higher insurance premiums. The bottom line is fraud has a big price tag on the American consumer,” Lynch said.

In addition, the NICB holds insurance fraud summits on an annual basis.

“They are what we call agenda setting exercises for a state to combat fraud,” said Lynch.”We’re doing our summit this year in October in the state of Colorado.”

As far as additional activity on anti-fraud legislation this year, Lynch said it is unlikely since most states adjourn in late May or early June; though some states have veto sessions.

Fraud-related legislation continues to pend in Michigan and Illinois.

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