NICB President and CEO Robert M. Bryant to Retire

Susan Q. Hood, Claims Vice President, State Farm Mutual Automobile Insurance Company and
Chair of the Board of Governors (BOG) of the National Insurance Crime Bureau (NICB) announced today that Robert M. "Bear" Bryant will retire as NICB President and Chief Executive Officer, effective at the close of business today, September 2, 2008.

At NICB, Mr. Bryant was the force behind the creation of Medical Fraud Task Forces and the Strategic and Tactical Information Department. He supported cutting-edge technology, such as license plate readers, bait cars and enhanced analytical tools for detecting fraud trends. He was an early and consistent voice nudging the NICB membership toward providing their salvage claims data to the public as a consumer protection against unsafe vehicles. His efforts materialized with the launch of NICB's member-supported VINCheckSM vehicle history service on June 30, 2008 -- a first-of-a-kind free benefit for the public.

In acknowledging the tenure of Mr. Bryant, Ms. Hood stated, "Mr. Bryant was responsible for remaking the NICB into the premier fraud-fighting organization it is today. His leadership, foresight and passion for excellence have touched every facet of NICB's operations delivering
efficiency, effectiveness, and a return on member investment that has grown from 2:1 upon his arrival to 8:1 presently. This is truly phenomenal and I know I speak for the rest of the Board of Governors in wishing Mr. Bryant a satisfying and well-deserved retirement. He will be missed."

The NICB Board elected NICB's Chief Operating Officer, Joseph H. Wehrle, Jr. to succeed Bryant as president and chief executive officer effective at the close of business today, September 2, 2008. "I am honored by the confidence the NICB Board has placed in me and I am excited to have the opportunity to lead this great organization. Thanks to Bob Bryant, the NICB is operationally sound and ready to move to the next level in our continued effort to accomplish our mission of combating insurance fraud and vehicle theft.

"I stand committed to continuing the cooperation that NICB extends to all of our partners including our member insurance companies, the entire property and casualty industry, law enforcement, state fraud bureaus, trade associations and all organizations focused on reducing the impact of fraud on the American public," said Mr. Wehrle.

"As a West Point graduate and retired Air Force Lt. General with over 33 years of service to the nation, Joe Wehrle brings a tremendous record of leadership and accomplishment to the NICB. His ability to attack the fraud problem while leading the NICB benefits from his previous experience as president of USAA Property and Casualty Group. He is uniquely qualified to direct the efforts of the NICB as it extends its excellent record of performance into new and challenging areas of insurance fraud activity," said Ms. Hood.

About NICB: The National Insurance Crime Bureau is the nation's premier not-for-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through information analysis, investigations, training and public awareness. Learn more at www.nicb.org.

Billions recouped in medical fraud

WASHINGTON — Whistle- blowers helped authorities recover at least $9.3 billion from health care providers accused of defrauding states and the federal government, according to an analysis of Justice Department records.

The department ramped up efforts in the 1990s to combat health care fraud by using private citizens with inside knowledge of wrongdoing. They now initiate more than 90 percent of the department's lawsuits focusing on health care fraud.

Whistle-blowers start cases by filing a sealed complaint in federal court. The department investigates the allegation and can intervene, assuming the lead role in the lawsuit. Whistle-blowers then get between 15 percent and 25 percent of the amount recovered.

Of the $9.3 billion recovered between 1996 and 2005, whistle-blowers got more than $1 billion, say analysts, writing for the Annals of Internal Medicine.

The analysts' findings are conservative. Information was available for only about three-quarters of the 379 cases reviewed. Also, some of the largest recoveries have taken place after the period reviewed.

For example, the study doesn't include the single largest settlement, worth $920 million, which came against Tenet Healthcare Corp., one of the nation's largest hospital chains, in 2006.

Still, the study highlights some important trends in health care fraud.

While the number of claims pursued has dropped in recent years, recovery amounts have soared because of a late addition to the cast of defendants — pharmaceutical manufacturers. Recoveries jumped from about $10 million a case in 2002 to $50 million by 2005.

Drugmakers are required to sell products to state Medicaid programs at the "best price" offered in the private marketplace, but the companies might artificially inflate the price, according to the report.

Another common scheme is to market drugs for uses not approved by the Food and Drug Administration.

The report's authors, Aaron S. Kesselheim of Brigham and Women's Hospital in Boston and David M. Studdert of the University of Melbourne in Australia, said data on hundreds of whistle-blower lawsuits should be researched to identify what types of allegations turn out to be legitimate and lead to recoveries so that the department can fast-track such cases.

By Kevin Freking
The Associated Press

Medical identity theft on the rise as health care desperation leads to crime

Although most identity theft cases in the United States involve credit cards and bank accounts, ID thieves are now engaging in medical fraud -- falsely obtaining medical care using someone's stolen identity -- according to today's Los Angeles Times.

After surgery on her shoulder last year, Lind Weaver, a 56-year-old retired schoolteacher, was billed for the amputation of her right foot. Refusing to pay the medical bill collectors, Weaver set about trying to prove that the surgery had obviously not been performed on her -- since her foot was intact -- which proved a more difficult task than recovering from simple credit card ID theft.

Experts say the rising costs of U.S. healthcare are driving medical identity fraud, and many victims are entirely unaware that their medical identity has been stolen unless they receive a hospital bill or an inquiry from their insurance provider. In addition to potentially damaging credit reports and affecting future job status -- since many Fortune 500 companies require access to medical records when hiring or promoting -- medical identity theft can also cause fatal future hospital errors.

For example, Weaver suffered a heart attack in May, and when she awoke in the hospital two days later, a nurse asked her what drugs she was taking to treat her diabetes. Weaver did not suffer from diabetes -- though the woman who stole her identity did -- and diabetes patients receive different heart surgeries than patients without the disease.

However, even if health complications are avoided, medical identity fraud can lead to hellish legal ordeals. In the case of Salt Lake City resident Anndorie Sachs -- whose ID was stolen and used when the thief delivered a baby that tested positive for methamphetamine -- her four children were nearly taken from her by social workers, though she had not given birth for two years. Sachs' case was only resolved after she hired a lawyer and went to the local media. However, when Sachs was admitted to the hospital for a kidney infection last year, the hospital records indicated the wrong blood type, which could have resulted in a fatal error.

Victims of medical identity theft find that clearing their names can be even more difficult than those clearing a traditional credit card ID theft, largely because of laws designed to protect patients' medical records. Once a patient reveals to the hospital or doctor's office that their medical records are somehow tied to someone else's -- even though that person is an identity thief -- their records become much more difficult to access.

The U.S. House and Senate are currently working to pass bills that push wider use of electronic health records, which could potentially make it easier for medical identity theft victims to clear their names.

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