The Register-Herald, Beckley, West Virginia

Editorials

August 31, 2010

Fraud

 

A recently completed audit of the state’s Public Employees Insurance Agency (PEIA) shows that nearly 10,000 — yes, 10,000 — people were receiving the benefit of health coverage or life insurance who shouldn’t have been. And the annual tab these illegally claimed dependents are costing the program figures out to be approximately $10 million.

That’s fraud, no matter how you dice it.

Taxpayers are footing about 80 percent of the bill for the PEIA program; they’re getting gypped.

Subscribers legitimately on the PEIA plan are suffering as well — certainly in the form of higher premiums/deductibles — since the program is costing $10 million more than it should.

PEIA’s chief financial officer, Jason Haught, told West Virginia MetroNews last Friday that the number of violators and the amount of money the program is losing aren’t out of the norm compared to other state-operated health insurance plans across the country.

While we all know there are always going to be some who will be illegally covered, the fact that we aren’t out of the ordinary with our percentages gives us little comfort.

While the penalties could include time behind bars, the best solution would be for the illegal benefits to be paid back to PEIA by the offending parties.

Packaged with the news just a day earlier that the state’s ailing unemployment fund has been making overpayments, it makes us a little wary when it comes to how effectively and efficiently these programs are being run.

Audits have been performed to bring these troubles to light. What our leaders do now to correct the problems is what we’re going to be closely watching in the weeks ahead.

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