Overpayment Recoupment Embezzlement Fraud Is Typically Committed Sophisticatedly By Health Plan's Third-Party Administrators (TPA) Or "Madoff TPA" For Failing To Refund Or Return The Recouped Overpayment Money To The Original Self-Insured Health Plans. "Anti-Fraud Initiative Is Not Complete Until And Unless The Recouped Overpayment Money Originated From The Plan Assets Is Finally Returned To The Original Self-Insured Health Plans, Or The Fake Anti-Fraud Crusaders Are The Real Fraud Culprit", Said Dr. Jin Zhou.
Hanover Park, IL (PRWEB) November 23, 2009 -- ERISAclaim.com announced today the new free Webinars for self-insured health plans to recover their plan assets from their TPA's in the new $1 trillion healthcare overpayment recoupment embezzlement market, after it launched the nation's first Embezzlement Recovery Services (ERS) to help midsized and large self-insured ERISA plans to get immediate relief from the economic recession and $2.5 trillion annual healthcare cost crisis.
The ERS Webinar is free to all self-insured ERISA plans. It is designed to review the industry facts and the applicable federal laws, and explain how and why a self-insured ERISA health plan should be refunded by its TPAs for recouped overpayment money.
These free webinars are scheduled for 30 minutes each session, from 12:30 PM to 1:00 PM CST on 12/23, 2009, 01/27/2010 and 02/22/2010.
Free registration information will be available at: http://erisaclaim.com/Embezzlement_Recovery.htm.
The ERISAclaim.com's new ERS service was created in the wake of the latest launch of Department of Justice (DOL) Financial Fraud Enforcement Task Force and recent Department Of Labor (DOL) enforcement initiative to prosecute "embezzlement of plan assets", and the reports of possible new $1 trillion successful and pending recoupment of the alleged healthcare overpayment, as reported from industry news and legislative testimony. More than 55% of employer-sponsored plan participants and beneficiaries are from self-insured ERISA plans, and the most recouped money for alleged overpayment or fraud were never returned to the self-insured ERISA plans that originally paid the allegedly overpaid healthcare claims as a part of $2.5 trillion U.S. health expenditure annually.
Both Senate and House Health Bills have claimed that another $849 billion or $1.025 trillion in 10 years will cover 94% or 96% of Americans. But both health bills have mandated employers and middle-class Americans to pay for most of these healthcare costs. If we know for sure right now there may be $1 trillion plan assets belong to employers and working Americans, why can't we take immediate actions to claim the part of $1 trillion to cover 95% of Americans?, said Dr. Jin Zhou, the president of ERISAclaim.com.
Overpayment recoupment means taking money back by self-insured plan TPAs from healthcare providers either due to the alleged pure fraud or retrospective benefit denial as the plan policy exclusion and limitation or clerical errors from TPAs and/or healthcare providers.
Overpayment plan assets recovery means returning, restoring or recovering the recouped money to the original ERISA plans that initially paid the alleged overpayment from the plan assets.
Overpayment recoupment embezzlement fraud is typically committed sophisticatedly by health plan's third-party administrators (TPA) or "Madoff TPA" in the scams by initial negligent overpayment to healthcare providers from the plan assets, especially from self-insured employer-sponsored plans, and subsequent unauthorized overpayment recoupment on behalf of self-insured plans under "anti-fraud initiatives" and ultimately fraudulent embezzlement of plan assets by failing to refund or return the recouped money to the original self-insured health plans, as explained by the industry expert, Dr. Jin Zhou.
The current overpayment recoupment embezzlement fraud is very sophisticated and complicated, as it was usually committed under anti-fraud campaign and with participation of federal and state law enforcement to the extent of the alleged healthcare provider fraud investigation and prosecution, noted by Dr. Jin Zhou.
Federal law, 29 U.S.C. §1106, Prohibited Transactions, specifically prohibits any TPA from embezzling, converting, or stealing the plan assets through the recouped overpayment money out of the plan assets.
Federal Law, 29 U.S.C. §1104, Fiduciary Duties, requires every plan administrator and fiduciary to defray reasonable expenses of administering the plan and to safeguard plan assets diligently with the care, skill and prudence. The self-insured ERISA plan administrators have statutory and fiduciary duties to recover overpaid claims from the plan assets from the plan's TPAs who successfully recouped the alleged overpayment regardless of reasons of overpayment.
"Anti-fraud initiative is not complete until and unless the recouped overpayment money originated from the plan assets is finally returned to the original self-insured health plans, or the fake anti-fraud crusaders are the real fraud culprit", said Dr. Jin Zhou.
As the Attorney General Eric Holder said at DOJ Financial Task Force Press Conference on November 17, 2009, that, "This task force's mission is not just to hold accountable those who helped bring about the last financial meltdown, but to prevent another meltdown from happening".
"It's not enough to prosecute fraud only after it's become widespread," Treasury Secretary Timothy F. Geithner said at the DOJ press conference. "We can't wait for problems to peak before we respond. We're seeking comprehensive financial reform to create a more stable, safer financial system and stepping up our enforcement strategy."
ERISAclaim.com believes that private sectors shall be the equal partners to the federal government in fighting and preventing another financial meltdown, and must take proactive and primary roles in conjunction with the government fraud task force to save our economy and healthcare system.
"Overpayment recoupment embezzlement is a widespread financial fraud that has gripped our healthcare system in a possible $1 trillion healthcare overpayment recoupment embezzlement crime, because most recoupment actions have gone back two to six years with $2.5 trillion health expenditure annually and $6 trillion in denied claims annually", said Dr. Jin Zhou, the president of ERISAclaim.com, an industry expert on overpayment claims.
"A successful enforcement and recovery from $1 trillion overpayment recoupment embezzlement market may very well finance the most, if not entire, healthcare reform, as the House Bill passed last week will provide coverage to 96% of Americans under $900 billion threshold outlined by President Obama", said Dr. Jin Zhou.
ERISAclaim.com announced this new free Webinar to help self-insured health plans to understand and assess the nature and the extent of the overpayment recoupment crisis, to recover and safeguard the plan assets in the new $1 trillion overpayment recoupment embezzlement market, including recouped and to be recouped money, not only from pure fraud but also from all retroactive denial of reimbursements for all denial reasons in absence of any fraud in the past 5 - 6 years.
For more information, or to arrange an interview, contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237, for free registration info, please visit http://ERISAclaim.com/Embezzlement_Recovery.htm.
Read the full story at http://www.prweb.com/releases/2009/11/prweb3244674.htm.
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