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Agenda Item
ASR
Control 06-000355 |
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MEETING DATE: |
03/07/06 |
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legal entity taking action: |
Board of Supervisors |
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board of supervisors
district(s): |
All Districts |
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SUBMITTING
Agency/Department: |
District Attorney
(Approved) |
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Department contact
person(s): |
Lisa Bohan-Johnston
347-8443 |
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Joe D'Agostino
347-8726 |
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Subject: Medical and Disability Insurance Fraud
Program
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ceo Concur |
County
Counsel Review |
Clerk of the Board |
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Concur |
Approved Agreement and Resolution to Form |
Discussion |
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3 Votes Board Majority |
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Budgeted: No |
Current Year Cost:
$600,000 |
Annual Cost:
N/A |
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Staffing Impact: No |
# of Positions:
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Sole Source:
N/A |
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Current Fiscal Year Revenue: $600,000 |
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Funding Source: State
100% |
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Prior Board Action: Board
Reso # 05-229 |
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RECOMMENDED ACTION(S)
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1. |
Authorize the submission of the attached Grant Award Agreement to accept State funds in the amount of $600,000.00 to participate in the State Disability and Health Insurance Fraud Investigation and Prosecution Program for the period ending June 30, 2006. |
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2. |
Adopt the attached Board Resolution superseding Board Resolution # 05-229, which changes the total grant award amount from $531,361.20 to $600,000.00. |
SUMMARY:
The Office of the District Attorney requests authorization to sign and execute the attached Grant Award Agreement with California Department of Insurance (CDI) to accept State funds in the amount of $600,000.00, which includes additional State funds of $68,638.80 to participate in the State Disability and Health Insurance Fraud Investigation and Prosecution Program for FY 2005-06.
BACKGROUND INFORMATION:
The Orange County District Attorney’s Office provides vertical prosecution of complex fraud or theft including insurance fraud cases. Currently, the Office receives State funds to participate in the State Automobile and Workers’ Compensation Insurance Fraud Investigation and Prosecution Programs. In recent years, the local office of State CDI has reported receiving an increased number of complaints involving medical insurance fraud as well as disability fraud suspected fraud referrals. For example, in 2001, the Office received information about a health insurance fraud involving outpatient surgery centers in Orange County. An investigation of this fraud has resulted in a large joint investigation with State CDI. The investigation continues to be ongoing and 10 defendants have been charged at this point in a fraud involving $96 million in fraudulent billings to health insurers and workers’ compensation insurer in a scheme where healthy patients are paid to undergo unnecessary surgical procedures.
By Resolution No. 05-229, your Honorable Board approved the Office to accept the State funding of $531,361.20 to be utilized by directing effort towards the investigation and prosecution of disability and health insurance fraud cases in FY 2005-06. The Office is requesting your Honorable Board approval to accept additional State funds of $68,638.80 for a revised total grant award amount of $600,000 for FY 2005-06.
The Office will coordinate with the CEO Budget Management Section to include the additional appropriations and revenues in the Quarterly Budget Report.
FINANCIAL IMPACT:
N/A
STAFFING IMPACT:
N/A
ATTACHMENT(S):
Grant Award Agreement.
Disability and Health Insurance Fraud – Sample Board Resolution