Northern West Virginia Forms Group to ID Health Care Fraud

State and federal authorities have created a multi-jurisdictional working group to identify and deal with health care fraud in northern West Virginia.

U.S. Attorney William J. Ihlenfeld II and representatives of the FBI, the IRS and the state Medicaid Fraud Control Unit announced the group’s formation on Nov. 12. Assistant U.S. Attorney Sarah Montoro is the group’s leader.

Ihlenfeld says investigators are using advanced statistical analysis of medical providers’ health care reimbursement data to identify potentially fraudulent billing patterns, waste and abuse.

Ihlenfeld announced a settlement of claims involving a Fairmont physician the same day. Dr. Samer Kuzbari paid $440,232 to resolve allegations that he submitted false claims to Medicare, Medicaid and other health care benefit programs.