News

May 26, 2010

Blue Cross and Blue Shield of Louisiana Anti-Fraud Efforts Reap More Than $6.8 Million for Policyholders in 2009

Blue Cross and Blue Shield of Louisiana (BCBSLA) stopped more than $6.8 million in losses due to healthcare fraud in 2009 - a savings that helps keep healthcare costs down for the not-for-profit mutual company's policyholder-owners.

BCBSLA's skilled fraud-fighting staff achieved these results using best-in-class software and working cooperatively with law enforcement to pinpoint and pursue fraudulent activity. Through this cooperation, BCBSLA also exceeded the Blue Cross system national average return on investment for anti-fraud activities of 9:1 by posting a 10:1 return for 2009.

"BCBSLA takes healthcare fraud very seriously and understands that all consumers pay when people steal from our system," said Darrell Langlois, Vice President, Compliance, Privacy, Fraud. "BCBSLA has been fighting healthcare fraud for more than 20 years, and we take a leadership role both locally and nationally to ensure our members are protected from this crime." 

Healthcare fraud is a dangerous and expensive crime that accounted for nearly three percent of all healthcare spending - or $69 billion in 2008 - according to the National Health Care Anti-fraud Association. Further, more than ever, patients can be put in harm's way when they get caught up in fraud schemes. In the last two years, BCBSLA has stopped three providers from physically harming patients and subjecting them to unwarranted surgeries or medications while billing for fraudulent services.  

BCBSLA has long held an aggressive stance against healthcare fraud. The recent healthcare reform debate highlighted the importance of these efforts, and BCBSLA joined the Blue Cross and Blue Shield Association in offering specific solutions to Congress on this very critical topic. Protecting resources from healthcare fraud promotes the accessibility and affordability of healthcare services, a key goal of reform. 

Today, at a 1 p.m. (Central) press briefing in Washington, D.C., the Blue Cross and Blue Shield Association (BCBSA) will announce that collectively in 2009, the Blue Cross and Blue Shield companies prevented more than half a billion healthcare dollars from being wasted on fraud, a 47 percent increase over 2008. The briefing will be webcast live at http://www.bcbs.com/news/bluetvradio/bcbs-companies-2009-aggregate-anti-fraud-statistics/.

"Blue Cross and Blue Shield companies are achieving significant gains in the war against healthcare fraud," said Scott P. Serota, CEO and president of BCBSA. "Blue companies are actively identifying and pursuing healthcare fraud in partnership with federal and state authorities, law enforcement and licensing boards. These efforts protect consumers' healthcare safety and safeguard healthcare affordability. Aggressive anti-fraud investigations help ensure critical healthcare dollars are being spent appropriately."

For more information about what the Blues are doing to combat healthcare fraud, or to view a webcast of today's briefing by BCBSA, please visit http://www.bcbs.com/news/bluetvradio/bcbs-companies-2009-aggregate-anti-fraud-statistics/. The webcast will be broadcast live at 1 p.m. Central time, and it will be archived at http://www.bcbs.com/ for future viewing.

To learn more about healthcare fraud or to report an incident to BCBSLA, please contact us at 1.800.392.9249 or visit http://www.bcbsla.com/ and click Company, then Report Fraud.

About Blue Cross and Blue Shield of Louisiana

Founded in New Orleans in 1934, Blue Cross and Blue Shield of Louisiana is the oldest and largest Louisiana-based health insurance company. Blue Cross is a not-for-profit, fully taxed mutual insurer, owned by policyholders and governed by a local Board of Directors. It is an independent licensee of the Blue Cross and Blue Shield Association.

The company provides group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to more than 1.1 million members. With headquarters in Baton Rouge and eight district offices, Blue Cross and Blue Shield of Louisiana employs more than 1,700 Louisianians who are committed to improving the lives of its customers by providing them with health guidance and affordable access to quality care.

Learn more on the company's website at http://www.bcbsla.com/ or on Facebook at www.facebook.com/bluecrossla. Follow Blue Cross on Twitter at www.twitter.com/BCBSLA and CEO Mike Reitz at www.twitter.com/MikeReitzCEO.

 

 

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