State proposes more insurer fees to fight fraud

In an effort to stop healthcare fraud, the California insurance commissioner sponsored a bill that would double the assessments that insurers pay to help the state fight fraudulent activity.

Under A.B. 2138, which passed the California Assembly last week, health and disability insurers would be assessed 20 cents per insured person, up from the current 10 cents per person. The extra fees would help support the California Department of Insurance and local district attorneys to investigate and prosecute health and disability insurance fraud, LifeHealthPro reported.

"Health and disability insurance fraud seriously hurts policyholders, providers, insurers, and ultimately California's economy," Insurance Commissioner Dave Jones said in a statement. "Unfortunately, this type of fraud is increasing in sophistication, complexity and volume. This higher assessment will provide much needed resources to fight this growing problem, especially in light of federal healthcare reform."

The California insurance department's insurance fraud task force has found the state lacks sufficient assessments to support a strong anti-fraud effort. The state received more than 6,000 potential health and disability fraudulent claims, but only a small fraction were referred to local district attorneys, which in turn only resulted in 184 convictions with an annual average of $223 million in chargeable fraud, the department noted.

The California Senate will now consider A.B. 2138.

To learn more:
- read the bill
- see the California Department of Insurance statement
- check out the LifeHealthPro article