46466081 - back pain.

Workers’ compensation fraud can be segmented into three types: employees, employers and healthcare providers. The most common type of employee fraud involves a fictional injury or illness that is non-work-related. Employers scam the system by misclassifying employees or neglecting to purchase workers’ compensation insurance coverage. Healthcare providers typically commit workers’ compensation fraud by convincing patients they need more treatments, make up a patient illness or injury, or simply bill for treatments that are not provided. That’s the case for our “Fraud of the Day,” an Akron, Ohio anesthesiologist.

While the majority of medical providers are honest, the doctor in today’s article was not. (Perhaps the 71-year-old physician wanted to catch up on his retirement fund, take a luxurious vacation or buy a new car. Who knows the reasoning behind his dishonest intentions?)

 It was a patient who tipped off the Ohio Bureau of Workers’ Compensation (BWC). The information provided claimed that the doc provided “inadequate care and falsified patient records.” (According to the investigation findings, that was so he could bill the BWC for services that were not provided.) In addition to being in short supply of scruples, the BWC also found the physician’s care to be lacking the level of care that injured workers deserve.

The pain specialist was convicted of workers’ compensation fraud and was ordered to repay the Ohio BWC $33,035. (This amount covered the improper payments he received and the cost of the BWC investigation.) He also agreed to stop treating injured workers in Ohio and surrendered his license to practice medicine and surgery for the rest of his life.

Today’s medical provider erroneously believed that he could pad his nest egg with funds that should have been directed to the care and well being of his patients. (Instead, it looks like he will now have to suffer the lack of $33,035 and the ability to make a living in his profession.)

Today’s “Fraud of the Day” is based on an article entitled, “Akron pain doc guilty of workers’ comp fraud,” published by Ohio Bureau of Workers’ Compensation on August 3, 2018.

COLUMBUS — An Akron pain specialist has agreed to reimburse the Ohio Bureau of Workers’ Compensation more than $33,000 and stop seeing injured workers in the BWC system after pleading guilty to a fifth-degree felony count of workers’ compensation fraud July 26.

Acting on a tip from a former patient, BWC investigators found Dr. William Midian, 71, provided inadequate care and falsified patient records so he could bill the agency for services he did not render.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.