Review urges fraud agency to make changes

A review by legislative auditors has prompted numerous policy changes at the state's top insurance fraud investigation agency.

An Office of the Utah Legislative Auditor General performance audit of the Insurance Fraud Division released Tuesday cited several issues that precluded the agency from more effectively accomplishing its function of investigating and prosecuting insurance fraud.

The audit showed that as of 2007, about 20 percent of the cases pursued and sentenced did not involve insurance.

Many health-insurance cases involved issues such as unrelated criminal activity involving illegal prescription drugs, Tim Osterstock, audit manager with the legislative auditor's office told the Deseret News.

As a result, he said, the agency's investigative costs increased significantly and yielded poor results.

Armand Glick, the divison's director, told the Deseret News that since he took over as head of the agency, the division has done everything necessary to address the concerns raised in the audit — a fact confirmed by Osterstock, who said the division "has been very responsive."

"They've made substantial changes in the organization," he said.

Glick said the changes included improving the screening system to ensure adequate investigation and prosecution of insurance-connected fraud cases. In addition, Glick said, the agency has developed a policy and procedure manual to prevent similar issues in the future.

"Our approach has been not to take a defensive position …(but) rather to listen to what they have to say," he said.

Glick said that the agency would continue to work to enhance their procedures to investigate fraud more effectively.

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