FARGO — The North Dakota Insurance Department’s fraud unit is investigating a suspected case of fraudulent medical insurance billing amounting to about $602,000, according to details contained in search warrant documents filed in Cass County District Court.
According to an affidavit accompanying the search warrant:
An investigator with the fraud unit received information in December 2015 from Blue Cross Blue Shield of North Dakota about suspected overbilling by a chiropractor who was working in the Williston area.
The insurance company analyzed claims submitted by the chiropractor and determined that out of 145 days billed by the doctor, the doctor claimed to have provided more than 20 hours of care per day on 108 days.
On one particular day alone the suspect claimed to have provided 73 hours of care.
Between August 2014 and June 2015, the chiropractor is suspected of inappropriately billing Blue Cross Blue Shield more than $602,000, according to the affidavit.
The search warrant sought phone record information for the chiropractor suspected of the overbilling.
It is not clear from the court filing whether the chiropractor is still working in North Dakota.
The suspect has not yet been charged.
Jeff Ubben, deputy insurance commissioner for North Dakota, declined to comment on the investigation, but he said insurance fraud is growing across the United States and is now the second-most profitable crime in the country after illegal drugs.
Ubben said medical-related fraud makes up about 10 percent the Insurance Department’s investigations, with automobile insurance fraud making up the the bulk of the agency’s caseload at 43 percent.
Insurance Department records show insurance fraud losses in North Dakota totaled more than $500,000 in 2016 and more than $1 million in 2015.
“Investigating insurance fraud and bringing individuals who commit these crimes to justice is one of the Insurance Department’s top priorities,” Ubben said.
To further that mission, he said the department recently started a program to help counties prosecute insurance fraud cases.
He said the program is working well in the two counties where it was started — Burleigh and Morton — and said there are plans to expand the program to more counties.
Ubben said one of the most common examples of how people commit insurance fraud in North Dakota is when vehicle crashes are staged to collect money from auto insurance companies.
“They’ll make, like, a quick turn into a lane,” he said. “They’re good at making it seem like it’s the other person’s fault.”