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National Insurance Crime Bureau

Illinois Orthopedic Surgeon Indicted

Medical Insurance Crime Files

 

There are many fraud schemes unscrupulous medical providers use to trick insurance companies out of thousands, and even in some cases, millions of dollars. According to the FBI’s Financial Crimes Report, billing for services not rendered is one of the most prevalent types of healthcare fraud. 

Law Enforcement requested The National Insurance Crime Bureau’s assistance investigating the alleged fraudulent billing practices of an Illinois Orthopedic Surgeon. NICB Special Agent Joseph Barrera teamed up with the Office of the Inspector General for this investigation. 

“We decided it would be a good idea to combine our investigation and NICB would take the liaison role with the insurance side because we could work directly with our member companies,” Special Agent Barrera said.  

Special Agent Barrera, along with agents from the FBI, DEA, HHS, and OIG, spent countless hours on the joint investigation.   

Thanks to cross-collaboration, the Orthopedic Surgeon was indicted in the United States District Court on 19 counts of insurance fraud.  

The NICB worked with the Federal Bureau of Investigation, U.S. Postal Inspection Service, Illinois Department of Labor, Illinois Office of the Inspector General, Drug Enforcement Administration, U.S. Food and Drug Administration, and multiple-member company Special Investigation Units on this case. 

Special Agent Barrera says this is a great example of how NICB partners with multiple agencies and our member companies to combat insurance crime. 

Anyone with information concerning insurance fraud or vehicle theft can report it anonymously by calling toll-free 800.TEL.NICB (800.835.6422) or submitting a form on our website.

About the National Insurance Crime Bureau: Headquartered in Des Plaines, Ill., the NICB is the nation's leading not-for-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through data analytics, investigations, learning and development, government affairs and public affairs. The NICB is supported by more than 1,400 property and casualty insurance companies and self-insured organizations. NICB member companies wrote over $525 billion in insurance premiums in 2019, or more than 82% of the nation's property-casualty insurance. That includes more than 95% ($241 billion) of the nation's personal auto insurance. To learn more visit www.nicb.org.