Fraud Assessment Commission

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Fraud Division Overview

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Investigation Division Overview

Fraud: Fraud Assessment Commission

Fraud Assessment Commission

The Governor makes Commission membership appointments to serve a four-year term, or until the Governor appoints a replacement. Originally, the FAC was comprised of five individuals representing self-insurers, insured employers, workers' compensation insurers, and the President of the State Compensation Insurance Fund, an ex-officio member. In September 2003, with the passage of AB 749, two additional Commission members were added to represent organized labor, increasing the membership to seven.

Fraud Assessment Commission Members
Name	Info/Bio
Lilia Garcia	Ms. Garcia's Bio
Donald Marshall	Mr. Marshall's Bio
Carol Newman	Ms. Newman's Bio
John Riggs	Mr. Riggs' Bio
Joel Sherman	Mr. Sherman's Bio
Jiles Smith	Mr. Smith's Bio
Douglas Williams	Mr. Williams' Bio

Fraud Assessment Commission Meetings

The date of the next Fraud Assessment Commission meeting will be posted here when it has been scheduled. Please check back.

Previous Meetings of the Fraud Assessment Commission
Agendas	Summaries
January 09, 2013 Agenda	The summary of the January 09, 2013 meeting has not been releaseed yet. Please check back.
September 12, 2012 Agenda	September 12, 2012 Summary
June 20, 2012 Agenda	June 20, 2012 Summary
January 11, 2012 Agenda	January 11, 2012 Summary
September 14, 2011 Agenda	September 14, 2011 Summary
June 15, 2011 Agenda	June 15, 2011 Summary
February 09, 2011 Agenda	February 09, 2011 Summary
November 16, 2010 Agenda	November 16, 2010 Summary
September 08, 2010 Agenda	September 08, 2010 Summary
June 16, 2010 Agenda	June 16, 2010 Summary
February 10, 2010 Agenda	February 10, 2010 Summary
September 09, 2009 Agenda	September 09, 2009 Summary
June 17, 2009 Agenda	June 17, 2009 Summary
January 13, 2009 Agenda	January 13, 2009 Summary
September 16, 2008 Agenda	September 16, 2008 Summary
June 17, 2008 Agenda	June 17, 2008 Summary
January 08, 2008 Agenda	January 08, 2008 Summary
September 11, 2007 Agenda	September 11, 2007 Summary
June 13, 2007 Agenda	June 13, 2007 Summary
March 01, 2007 Agenda	March 01, 2007 Summary
November 29, 2006 Agenda	November 29, 2006 Summary
July 27, 2006 Agenda	July 27, 2006 Summary
June 20, 2006 Agenda	June 20, 2006 Summary
January 18, 2006 Agenda	January 18, 2006 Summary
December 14, 2005 Agenda	December 14, 2005 Summary

In Fiscal Year 2007-08, the Department contracted with the Regents of the University of California through the University of California at Berkeley to conduct an extension of research that was previously funded by the California Commission on Health and Safety and Workers' Compensation. The research titled "The Fraud in Workers' Compensation Payroll Reporting Study" analyzed the degree to which employers under-report or misreport payroll for workers' compensation insurance purposes. This research study was presented to the Fraud Assessment Commission in January 2009.

The report concluded that in the year 2005 alone, under-reported insurance premiums ranged from $2.09 billion to $2.87 billion. Furthermore, the report indicates that several high-risk employers have fraudulently misreported their workers in high-risk/high-premium classes as earning wages in lower-risk occupations, accounting as much as 40 to 60 percent of payroll.

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A research study, commissioned by the Fraud Assessment Commission, to determine the extent of medical overpayments and underpayments, was completed in June 2008. The results of this study, the first to measure medical payment accuracy in California, quantify what the experts in workers' compensation fraud detection have known for some time: medical provider fraud is one of the primary cost drivers that inflate the cost of claims and insurance premiums. That is why this area of workers' compensation insurance fraud has been given one of the highest priorities in Fraud Division investigations.

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