June 27, 2007

Blue Cross and Blue Shield of Louisiana’s Anti-Fraud Efforts Receive National Attention

Blue Cross and Blue Shield of Louisiana was named the Health Care Fraud Case of the Year winner under BlueWorks, a program of the national Blue Cross and Blue Shield Association that recognizes Blue Plans for outstanding performance in various categories. The award was presented at the 2007 National Internal Audit and Anti-Fraud Conference.

The winning case was that of James T. Hill, M.D., a Shreveport doctor who provided hundreds of painkiller prescriptions to patients whom he had not examined. Many of the doctor’s patients sold their prescriptions illegally, and one patient died of an overdose while others developed serious addictions. Blue Cross and Blue Shield of Louisiana’s Financial Investigations Office assisted the U.S. Attorney’s Office – Western District, FBI and other law enforcement agencies in gathering evidence that was used successfully to convict Hill of illegally prescribing large quantities of narcotics. Hill was sentenced on March 21, 2007, to more than 16 years in prison.

“Healthcare fraud costs every insured American about $200 per year. I’m proud that our Financial Investigations Office could help lower that cost and protect our customers in the Shreveport area by assisting in the investigation of Dr. Hill,” said Darrell Langlois, compliance and privacy officer at Blue Cross and Blue Shield of Louisiana. Learn more about BCBSLA's fraud efforts.

The BlueWorks award program is a unique collaboration between the Blue Cross and Blue Shield Association and Harvard Medical School’s Department of Health Care Policy. BlueWorks generates awareness and recognition of successful Blue Plan initiatives that effect change and improve healthcare and the healthcare system.

Blue Cross and Blue Shield of Louisiana is Louisiana-owned and -operated. Marking its 73rd anniversary this year, the company is an independent licensee of the Blue Cross and Blue Shield Association. It is a tax-paying mutual company, owned by its policyholders. Headquartered in Baton Rouge, also has district offices in Alexandria, Houma, Lafayette, Lake Charles, Monroe, New Orleans and Shreveport. The company’s subsidiaries include HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc.