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Payers Scouring Social Media for Cheaters

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  • In Audit
  • January 28, 2011
  • Comments Off on Payers Scouring Social Media for Cheaters

Do you have a long-time patient with a chronic problem whose coverage just ended? The cancellation may be because of what he or she has been posting on social network sites like Facebook or Twitter. Commercial payers, especially those handling workers’ compensation and other long-term care, are watching patients’ posts for signs of fraud, according to a recent article in the Los Angeles Times.
Posts that appear contrary to a patient’s diagnosis and care are raising eyebrows, the article says; and examples are plentiful, such as a patient with a disabling injury who discusses or posts pictures of water-skiing or completing a marathon. The risk for payers is not to move too quickly or drastically, legal experts warn. Photos posted on these sites may be old, as in the example of a profoundly depressed woman whose pictures of her enjoying a party caused the payer to act.
This social media angle impacts patients’ caregivers as well, who could be construed as aiding and abetting.

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