Health Insurance Fraud

The nation's bill for health care fraud was estimated to total $85 billion in 2003 by the Blue Cross and Blue Shield Association and the U.S. Government Accountability Office, or 5 percent of U.S. health care spending. For Medicare, $1 out of every $7 was lost on fraud and abuse.

Fraud and abuse take place at many points in the health care system. Doctors, hospitals, nursing homes, diagnostic facilities and attorneys have been cited in scams to defraud the system. One huge area of fraud is the Medicare and Medicaid systems. Health care is especially susceptible to electronic data interchange (EDI) fraud. EDI is direct filing of claims - computer to computer - and is widely used for Medicare claims. According to the Health Insurance Association of America, at least a quarter of health insurers' claims are sent electronically. Most insurers that use EDI implemented a fraud screening device.

In 1999, the Government Accounting Office released a study of the Medicare, Medicaid and private health insurance sectors that confirmed that organized crime is heavily involved in health care fraud. The investigation found that in seven cases of health care fraud studied, about 160 health related groups - medical clinics, physician groups, labs or medical suppliers - had submitted fraudulent claims. The criminals identified in the report were not health care workers but criminals already prosecuted for securities fraud, forgery and auto theft. Apparently, these criminals had moved to health care because fraud was relatively easy to accomplish. Offenders were extremely mobile, moving from New Jersey to California, for example, before authorities in the first state could arrest them. The criminals illegally obtained beneficiary names and medical provider numbers.

The detection and prosecution of health care abuse received a boost from a provision included in the Health Insurance Portability and Accountability Act of 1996 (see Federal Legislation section), which was responsible for recovering more than $1 billion for the Medicare Trust Fund. The money went into a fund designed to bolster law enforcement efforts by paying for computers, consultants and training sessions, according to a former deputy chief of the Health Care Fraud Task Force. The Department of Justice called health care fraud and abuse its number two law enforcement priority, after violent crime.

Client Reviews

Empire Pacific Investigative Services

4.8

Based on 88 reviews

Kim J.
My Son found Mike at Empire Pacific because we needed a detective in order to find someone. We had spend a lot of time and money on many search people websites and never found anything current on the person we were trying to find. We hired Mike to do an initial check to find the person. Mike called and said on the initial check that he had found what we needed, he said the second step would be to go look by foot and there would be a fee per hour. About 2 hours later Mike called and told us he had found the person and gave me his current phone number. I called and sure enough it was the person I was looking for. Now this shows how honest Mike is because he could have easily billed me for a few extra hours of leg work (which is paid per the hour) and I would not have known he already found the person. Mike was very attentive when I called and either picked up his phone or called me back very fast. I would highly recommend Mike, he is vey good at what he does and is respectful, honest and FAST!
Agustin C.
Mike Hakimi from EPIS is a true professional. He helped me with my case. He delivers effectively and fast! I was trying to find someone that nobody has heard from him from since the late 90's, I was very unsure he was still around. I needed to find him and interview him for my movie project. A key character. And Mike incredibly found him. Don't hesitate hiring Mike for any type of service.
Shera C.
Very pleased with Mike and his staff. Thank you for handling this surveillance case on such short notice. I was very pleased with your services and will do biz again with you for sure. I will be in touch:) 5 Stars!!!
Lance R.
Mike and his team are as professional as it gets. Very prompt to reply and understand the finesse needed in this service. I appreciate his expert feedback and how to best proceed in the most efficient way possible. Thank you again!!!

-LRR
Yossi S.
I have highest, highest praise for Mike at Empire Pacific Investigative Services. I had to take someone to court and I was concerned whether sheriff is efficient enough to do the serving or they will just attempt and I pay for nothing. I talked to Mike about serving this particular person and on top of it I try to force future steps of collection and Mike was extremely helpful to show me in and outs of all the options that I have and how he can help me.

My concern was the person that I am suing would play hide and seek, not available during the day and difficult to catch. Sure enough Mike served the paper within 2 to 3 days and informed me accordingly.

I am so happy to know Mike and would not hesitate to recommend him to anyone that has needs for his services.
Kevin O.
I was searching for a family relative, for over 40+ years with no such luck. So I decided to find a private investigator. I contacted Mike at Empire Pacific Investigative Services and in the same day he found the person I was looking for easily. I was so blown away! This service is AAA+ and I would definitely use them again, again and again! Thank you Mike!
Deborah O.
Top notch experience with Empire and Mike!
No lag time or waiting around. He gave me the difficult diligence I needed within the week.
Professional, friendly and available whenever I need the.
Prompt response time and easy to reach!
Thanks Mike! I'll be using your services again. Wouldn't go to anyone else!

Deb Olberding
Magda S.
I had very good experience with Empire Pacific Investigative Services, Mike was very determined and efficient, detail oriented and reliable. His work effect exceeded my expectations.
Yossi S. Los Angeles, CAV
0 friends
4 reviews

11/20/2017

I have highest, highest praise for Mike at Empire Pacific Investigative Services. I had to take someone to court and I was concerned whether sheriff is efficient enough to do the serving or they will just attempt and I pay for nothing. I talked to Mike about serving this particular person and on top of it I try to force future steps of collection and Mike was extremely helpful...

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Agustin C. Los Angeles, CA
10 friends
3 reviews

4/26/2018

Mike Hakimi from EPIS is a true prfessional. He helped me with my case. He delivers effectively and fast! I was trying to find someone that nobody has heard from him from since the late 90's, I was very unsure he was still around. I needed to find him and interview him for my movie project. A key character. And Mike incredibly found him. Don't hesitate hireing...

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Marcus B. Ewa Beach, HI
32 friends
86 reviews

2/27/2018

I contacted Mike at Empire to do some research for me on an old insurance claim. It ended up not being along the lines of work that he was an expert in but what was so great about the experience was that Mike went out of his way to find me someone that did specialize in the area. If you are considering a couple options on who you need for your investigation you...

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Magda S. New York, NY
27 friends
2 reviews

3/21/2018

I had very good experience with Empire Pacific Investigative Services, Mike was very determined and efficient, detail oriented and reliable. His work effect exceeded my expectations.

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Shera C. Orange, CA
8 friends
24 reviews

2/27/2018

Mike's firm is awesome. I gave them short notice to conduct surveillance and they totally delivered. Thank you and your staff for handling this assignment for me on such short notice...

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Jonatan C. Chatsworth, Los Angeles, CA
0 friends
8 reviews

8/25/2017

I have worked with a few private investigation firms, and in my opinion, Empire Pacific Investigative "Mike Hakimi" is the best one...

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