At Work

Fraud … fraud? Yes, but

Who was asleep at the switch?

N.J. woman sentenced to 5 years in $940K health care fraud case

Kim Bogan of Brick Township, N.J., received a five-year prison term and was ordered to pay $941,354.77 in restitution after pleading guilty to theft by deception in October for defrauding the township’s insurance program. Bogan submitted more than $940,000 worth of fraudulent claims to the township’s self-funded health insurance program for chiropractic services supposedly rendered by her now-deceased brother, Glenn Scarpelli, from January 2011 to April 2017, according to authorities.

Patch (1/2),  NJ Advance Media (Morristown, N.J.) (1/2)

Let’s do some math.

The typical chiropractic visit costs $60. This person submitted claims for herself and family members. To reach that total spending there would be a total of about 15,689 visits or 2,614 visits a year.

Fraud yes, but holy cow, who in the health insurance plan was asleep at the switch? This is the kind of abuse that should easily be detected long before six years. This is what you typically hear from Medicare🤕 years to uncover fraud because of the way claims are processed.

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