WASH. L&I ENFORCES NEW ANTI-FRAUD LAWS:

Anti-fraud legislation passed in March took effect June 10, giving the Department of Labor and Industries (L&I) broad new authority to combat fraud and abuse of the workers’ compensation insurance system. A change in the law governing successorship means that employers no longer will be able to avoid insurance premiums by closing a business and reopening a new one with a clean slate in regards to business taxes. Other changes will make it easier for L&I to prove fraud cases against workers, employers and health-care providers who knowingly cheat the industrial insurance system. When the state Legislature passed the anti-fraud measures in March, it also gave L&I additional resources to expand its fraud staff. Ten new investigators and auditors are being hired, and some existing L&I positions are being transferred to the anti-fraud effort. The agency recently named Carl Hammersburg to head the program. L&I’s focus on combating fraud and abuse is in response to concerns expressed by employers and some workers. At rate hearings over the past two years, they told L&I that invalid injury claims, and employers who don’t pay the premiums, put an unfair financial burden on companies that support the insurance system. L&I set out to overhaul the way it manages claims and how it uncovers, investigates and pursues fraud and abuse of the system by workers, employers and health-care providers. The agency reassigned additional people to combat fraud and abuse, and it adopted new procedures for investigations and audits. In addition, it requested legislation that would make it easier to prove fraud and harder to avoid business taxes. With the additional staff, L&I will conduct more validity checks to make sure new workplace-injury claims are legitimate. The agency’s auditors will perform more random audits of businesses to make sure they are accurately reporting hours worked and paying premiums. L&I investigators will crosscheck with other government agencies to find workers who are collecting L&I benefits while secretly working at other jobs. New software programs will soon improve L&I’s ability to detect duplicative and improper billings by health-care providers.

Topics Fraud