Newsline No. 19-06
April 12, 2006

The Division of Workers’ Compensation posts information on reporting suspected medical care provider fraud

The law* requires any insurer, self-insured employer, third-party administrator, workers' compensation administrative law judge, audit unit, attorney, or other person that believes a fraudulent claim has been made by any person or entity providing workers’ compensation medical care to report the apparent fraud to the administrative director of the Division of Workers’ Compensation (DWC).

The DWC has developed protocols, in cooperation with the California Department of Insurance and Department of Justice, for reporting suspected medical care provider fraud. This information, along with a fillable fraud reporting form, is posted on the DWC Web site. Find the protocols and the form at http://www.dir.ca.gov/dwc/MedicalCareProvider/MedicalCareProviderLC3823.htm.

*Labor Code section 3823

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