July 26, 2012

Blue Cross and Blue Shield of Louisiana Partners with Federal Government to Fight Healthcare Fraud

Blue Cross and Blue Shield of Louisiana has been selected as one of a handful of private health insurance plans to join a groundbreaking partnership between the government and private payers to fight healthcare fraud. Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder today announced the Federal Fraud Partnership, a historic agreement to work together and share information that could prevent and combat fraud.

Because Blue Cross and Blue Shield of Louisiana has been for many years so active in this fight, the company is one of only a few private insurers from around the country to be invited to join the partnership. “We are honored that Blue Cross is seen by the highest-ranking officials in Washington as a major factor in the fight against healthcare fraud,” said Mike Reitz, Blue Cross president and CEO, who was in Washington, D.C., along with Sebelius and Holder to help formally announce the Fraud Prevention Partnership. “Today’s announcement is the culmination of years of effort to recognize the results that can be achieved when the public and private sides work together so seamlessly.”

Blue Cross and Blue Shield of Louisiana has long been a leader in fighting healthcare fraud, which costs billions each year and drives up healthcare costs. This in turn affects both private insurance premiums and the state and federal income taxes that pay for Medicare and Medicaid.

“Whether you are paying taxes or premiums or both, you are affected by this nemesis,” said Reitz. “Like any other major crime, the public needs to work with government and law enforcement to make a difference for the greater good. That is what we are accomplishing today.”

He added, “Together, the government and private payers can achieve remarkable results in stopping those who bilk our healthcare system of billions of dollars each year.”

Blue Cross and Blue Shield of Louisiana started a dedicated fraud investigation unit in 1992, and since that time, it has returned millions of dollars to Blue Cross members through its efforts. In addition, senior Louisiana Blue Cross leaders have played a role in combating fraud at the national level through participation on boards and committees dedicated to fighting this issue. In 2011, fraud prevention and investigation efforts by all Blue Plans combined generated more than $295 million in savings and recoveries—a return on investment of five to one. And, 197 criminal convictions resulted from combined Blue Cross investigative referrals.

Other Fraud Prevention Partnership participants will include the Blue Cross and Blue Shield Association, America’s Health Insurance Plans and the National Association of Insurance Commissioners. The government is represented by the Department of Justice, the FBI, Centers for Medicare and Medicaid Services, and the Department of Health & Human Services-Office of the Inspector General. 

Reitz said all of those represented recognize that the healthcare system and the American people need them to join forces to protect their families and their healthcare dollars. “Together, all of these groups can create a clear picture of criminals who otherwise might not be noticed,” Reitz said. “Together, efforts to identify and then stop these criminals will be far more productive and sustaining than if we operate independently.”

He added, “This is another example of how BCBSLA works to protect the premium dollar of our members and strive to keep healthcare affordable. Our customers and all Louisianians should be proud that Louisiana is being recognized as a leader in this fight.”

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 private, fully taxed mutual company, owned by policyholders—not shareholders—and governed by a local Board of Directors. It is an independent licensee of the Blue Cross and Blue Shield Association.

The company and its subsidiaries provide group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to more than one out of every four Louisiana residents. With headquarters in Baton Rouge and eight district offices, Blue Cross and Blue Shield of Louisiana employs more than 1,900 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 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