ICW Group SIU Uncovers Massive Medical Billing Fraud, Leads to Indictments

ICW Group Special Investigations Unit (SIU) Senior Investigator, Vic Beyer, conducted a complex, multi-year investigation into Blue Oak Medical Group which has now led to 181 felony criminal charges being filed against eight individuals. The individuals are accused of attempting to defraud the California Workers’ Compensation system of at least $123 million in alleged medical costs for treatments and medications which the patients are suspected to rarely, if ever, have received.

ICW Group SIU’s investigation into this entity was launched prior to the first medical bill ever being submitted — a credit to the predictive sophistication of ICW Group’s data analytics functions. Vic, in conjunction with ICW Group SIU’s Fraud Analytics Team, immediately conducted a full-scale investigation, quickly identifying key elements of the apparent billing scheme along with its suspected operators.

In collaboration with ICW Group Claims Management, a defense plan was swiftly put into place which has successfully saved ICW Group customers millions of dollars in unnecessary and questionable claims costs.

The speed of bringing a case of this complexity and scale to prosecution consideration is believed to be unprecedented and directly related to the unwavering investigative work done by ICW Group Special Investigations Unit, the collaborative assistance of ICW Group’s Claims Department, and the dedication and hard work of numerous law enforcement agency partners.

ICW Group SIU will continue to cooperate with law enforcement as this prosecution proceeds.