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Blue Cross and Blue Shield Companies' Anti-Fraud Units Recover and Save More Than $249 Million In 2007
Date:6/19/2008

Plan representatives call efforts key to Blue companies' stewardship of healthcare dollars

WASHINGTON, June 19 /PRNewswire-USNewswire/ -- Blue Cross and Blue Shield companies' anti-fraud investigations resulted in overall savings and recoveries of more than $249 million last year, according to data released by the Blue Cross and Blue Shield Association (BCBSA). The combined return and savings result for all Blue Cross and Blue Shield companies' anti-fraud units was $5 dollars for every $1 dollar spent on anti-fraud efforts.

BCBSA released the findings from its annual survey of Blue Cross and Blue Shield companies' anti-fraud activities at a briefing to highlight the growing problem of healthcare fraud and medical identity theft. Panelists at the briefing included Gregory W. Anderson, chair of the BCBSA National Anti-Fraud Advisory Board (NAAB) and vice president, corporate and financial investigations, Blue Cross Blue Shield of Michigan; Michael Brandt, senior manager, special investigations, Blue Shield of California; and James Quiggle, director, communications, Coalition Against Insurance Fraud.

"Blue Cross and Blue Shield companies - in partnership with consumers, law enforcement, licensing boards, and authorities - are actively identifying and pursuing healthcare fraud in an effort to assure healthcare affordability," said Byron Hollis, managing director of BCBSA's National Anti-Fraud Department. "Healthcare fraud wastes critical resources, and investigations can help make sure money is being spent on healthcare that meets consumer needs."

Blue Cross and Blue Shield companies' anti-fraud investigators collectively prevented $134 million from being spent on fraudulent or erroneous medical claims, while recouping nearly $115 million paid on fraudulent claims. Nationally, Blue Cross and Blue Shield companies' anti-fraud investigators opened 13,424 cases.

Other statistics from the BCBSA survey include:

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SOURCE Blue Cross Blue Shield Association
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