health care fraud

Blue Cross Blue Shield of Michigan’s new advanced analytics anti-fraud solutions to be featured at national conference

Fraud, waste and abuse cost health plans and their members up to $270 billion annually. As those committing fraud become more sophisticated, health plans need equal sophistication to see relevant patterns in a growing sea of data. To fight improper … Continue reading

Work by Blues investigators helps stop pharmacy health care fraud ring in Michigan

Federal authorities called it one of the largest diversion conspiracies ever uncovered in Michigan. Investigators from Blue Cross Blue Shield of Michigan’s health care fraud unit played an important role in cracking the case that saw a Canton pharmacist and … Continue reading

The Blues Anti-Fraud Unit Recouped More Than $270 Million

Blue Cross Blue Shield of Michigan’s health care fraud investigation unit, the oldest and most successful health plan operation of its kind in the U.S., saved or recovered nearly $277 million since it first began operation nearly 30 years ago. … Continue reading

CNBC’s ‘American Greed’ features Michigan health care fraud case cracked by Blues

A dark side of health care fraud will be revealed tonight on CNBC’s “American Greed” when the program reports on a Michigan doctor who bilked insurers, Medicare and patients out of at least $1.9 million. The program profiles Dr. Robert … Continue reading