USPS OIG: Workers’ Compensation Provider Fraud

The financial impact to the U.S. Postal Service from workers’ compensation fraud cases is so significant, it warrants a good deal of investigative attention. Our special agents – often working with other law enforcement partners – investigate fraud by claimants or providers.

The Federal Employees’ Compensation Act provides workers’ compensation benefits to civilian federal employees, including postal workers, who sustain work-related injuries or an occupational disease. It also provides for the payment of benefits to dependents if a work-related injury or disease causes an employee’s death.

Most postal workers who collect compensation benefits have legitimate claims for on-the-job injuries that prevent them from performing any postal jobs. Likewise, the vast majority of medical providers operate in good faith, abiding by all laws. However, a few providers used by injured postal employees submit false bills or falsify claim documents, sometimes endangering claimants the program was designed to protect.

Recent cases show how provider fraud can go on for years, resulting in multi-million-dollar schemes. In one recent case, a doctor in San Antonio billed the workers’ comp program more than $7.5 million over a four-year period for physical therapy and treatment by a qualified professional when, in fact, unlicensed technicians provided services.

In another case, a generic pharmaceutical company was charged with price fixing – the fourth charge in the Department of Justice’s ongoing criminal investigation into the generic pharmaceuticals industry. The company agreed to pay fines, penalties, and restitution totaling millions of dollars.

Please visit our document library to see all news releases on closed cases that involved us. And remember, if you need to report fraud, waste, or abuse, all you have to do is click here to reach our Hotline.

Source / Comments: Provider Fraud Focus | USPS Office of Inspector General

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