Express Scripts clients being extorted, too

Anne Zieger — Thu, 13 Nov 2008 08:52:38 -0500

Last week, Express Scripts broke the news that someone was threatening to extort them for an undisclosed amount. The extortionist said that if Express Scripts didn't pay up, they would release members' personal information. Now some of the pharmacy benefit manager's clients are also being extorted, in letters that are reportedly similar in style to the original extortion letter.

Express Scripts has reported the letters to the FBI and has been working with them to attempt to discover who is responsible. The PBM is also offering a $1 million reward for "the person or persons who provide information resulting in the arrest and conviction of those responsible for these criminal acts."

In case there was any question that healthcare organizations needed to fight identity theft just like any other creditor, this case should provide an answer: a resounding yes.

To learn more about the extortion efforts:
- read this Modern Healthcare piece (reg. req.)

Consortium formed to fight medical fraud

Abby Christopher — Wed, 25 Jun 2008 12:12:22 -0400

The FBI is among several groups that have jointly established a new consortium of insurance investigators and other stakeholders to help fight medical fraud.

Participating groups include Consortium Against Insurance Fraud, the National Health Care Anti-Fraud Association, the National Insurance Crime Bureau, the Fraud Section of the Justice Department's Criminal Division and the FBI's Health Care Fraud Unit. The new group will facilitate cross training among health insurance and property/casualty insurance investigators. This will help them to understand each other's strategies and build cases against individuals and organizations suspected of medical fraud.

Earlier this month, Booz Allen won a $450,000 contract with the HHS's Office of the National Coordinator for Health Information Technology to determine and size and scope of medical fraud in the United States.

For more information:
- read the full Washington Business Journal story