The Texas Division of Insurance coverage’s Fraud Unit contributed to investigations touchdown almost $58 million in court-ordered restitution final 12 months.
In line with TDI, greater than 20 TDI investigators stationed across the state regarded into over 350 insurance coverage fraud allegations with a objective of specializing in circumstances with the most important attainable impression.
“If we recoup restitution for insurance coverage firms and shoppers, hopefully that causes much less of a rise in premiums,” stated Kyson Johnson, a TDI lawyer, in an announcement. “These firms and shoppers are now not uncovered to the fraud.”
One investigation helped cease Dallas medical doctors Desi and Deno Barroga, TDI stated. Barroga, 51, and Barroga, 51, have been indicted in November 2023 and pleaded responsible in Might 2024 to 1 depend every of conspiracy to commit healthcare fraud. The 2 had been overprescribing opioids and falsely billing well being plans by hundreds of thousands of {dollars}.
“These medical doctors exploited drug customers’ vulnerabilities, requiring them to undergo month-to-month visits in alternate for managed substance prescriptions, then billing their insurance coverage suppliers for providers the sufferers didn’t want nor obtain,” stated U.S. Lawyer Leigha Simonton in September 2024. “In a weird try and cowl up their crimes, the defendants feigned giving injections with out really piercing the sufferers’ pores and skin.”
Data collected by a TDI investigator helped the FBI and different companies construct a legal case, the TDI famous. The medical doctors pleaded responsible and have been sentenced to jail. A U.S. district choose ordered them to pay $9 million in restitution. Each males additionally have been required to surrender their medical licenses
The TDI advises shoppers to report fraud at: https://www.tdi.texas.gov/fraud.
Supply: Texas Division of Insurance coverage.
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Texas
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