Undercover Agent Posed as Injured Worker to Spot Billing Fraud

Friday, November 16, 2018 | 0

Six months after a physical therapy firm owner pleaded guilty to fraud, the Ohio Bureau of Workers' Compensation explained how it busted the man.

First, the bureau in 2013 noticed that an inordinate number of bills from PT Plus LLC, of Willoughby Hills, were for treatment of a company co-owner and others connected to the firm, the BWC investigations department explained in a bulletin posted Thursday.

The bureau had an undercover agent pose as an injured worker. Over 23 visits, the agent observed that PT Plus billed the state-run compensation system for services that were never rendered.

In one case, the agent saw an injured worker refuse treatment, but records showed that the company billed the BWC anyway, Jennifer Cunningham, assistant director of the bureau's investigations department, wrote Wednesday.

Investigators also interviewed employees of the physical therapy shop, which went out of business in 2014.

The owner of the firm, Jeffrey Guerin, gave various explanations about the billing, but then pleaded guilty in May to workers' compensation fraud. He paid $7,150 in restitution.