California’s Department of Industrial Relations issued a release on their anti-fraud efforts in the state’s workers’ compensation system. In 2016 the DIR put together a group of stakeholders in the fight against fraud and in 2017 the group published an initial report outlining fraud in the system and suggesting changes.

The report gives an update over last year’s findings, including results from the two laws which took effect January 1^st of 2017.  SB 1160 requires the DIR to stay liens filed by providers who had been indicted or charged with a crime. At the time of this report, 465,000 such liens had been automatically stayed. Since 2017 the department has dismissed 292,000 liens, with claim values of $2.5 billion, for failing to file the required declarations. AB 1244 requires the Division of Workers’ Compensation (DWC) Administrative Director to suspend providers from the system who are convicted of fraud. The DWC has since suspended 227 medical providers.

“DIR’s anti-fraud efforts have allowed us to remove fraudulent providers and their claims for payment from the system, with the aim to improve services and reduce premium costs,” said DIR Director Christine Baker. “Our fraud prevention work also involved identifying fraudulent activity through data analytics and defending anti-fraud laws in court.”

Read the press release and more about the state’s fraud prevention efforts here