Copyright held by The John Cooke Fraud Report. Reprint rights are granted with attribution to The John Cooke Fraud Report with a link to this website.
The recent conviction of Michael Kerr, owner of Kerr Chiropractic Center in Toledo, has proven to be one of the largest provider fraud cases ever investigated by the Bureau of Workers’ Compensation (BWC) Special Investigations Department. Had Kerr not been convicted, BWC estimates he could have stolen more than $3 million.
In late 1994, the FBI received an anonymous complaint alleging Kerr was being paid for services not actually being performed on his patients. The tip was shared with BWCUs SIU and became part of an ongoing investigation. The fraud units of Community Mutual of Ohio and Progressive Insurance were also notified.
A joint investigation began and evidence was collected confirming the allegations. In joint undercovers, the FBI and BWC agents posed as patients and visited Kerr’s office to strengthen the case.
In October 1997 a search warrant was obtained and served on Kerr’s office, seizing all of his medical records. A joint cross match by BWC, Community Mutual and Progressive took place. Six months later, Kerr signed a plea agreement, calling for, among other considerations, the surrender of his medical license.
More than 2,000 cases of suspected workers’ compensation fraud are currently under investigation by BWCUs SIU Q trying to stave off the estimated $80 to $160 million of potential yearly fraud losses. Since 1995, more than $166 million in fraud has been identified and more than 170 people have been convicted. There have been 75 indictments thus far in 1998.
BWC has used investigators and sophisticated computer cross-matches to identify those bilking the system. Fraud investigators work through BWC Service Offices throughout Ohio with claims representatives, training them to recognize warning signs that signal fraud. Joint computer cross match programs with the Ohio Bureau of Employment Services and the Ohio Department of Rehabilitation and Correction have also located hundreds of workers’ compensation cheats. BWC is also part of the Joint Health Care Task Force coordinated by the US Attorney’s Office.
© Copyright 1998 Alikim Media