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Fraud Statistics
Health care fraud is a serious crime. Under Michigan's Health Care False Claims Act, it's a felony, punishable by up to four years in prison, a $50,000 fine, and loss of health insurance.
Blue Cross Blue Shield of Michigan's fraud investigation unit coordinates investigations with law enforcement agencies such as the Federal Bureau of Investigation, The Office of Inspector General for the Department of Health and Human Services, Michigan State Police, local police departments, and state and federal prosecutors.
The Blues are committed to protecting members and providers and keeping down the cost of health care by stopping fraudulent activity. The following data represents Blue Cross Blue Shield of Michigan's fraud investigation unit activity from July 1980 to September 2009.
| Cases Opened | Cases Closed | Referred for Recovery/Cost Savings |
|---|---|---|
35,856 |
34,291 |
$275,245,797.19 |
Many cases handled by BCBSM's fraud investigation unit result in further action by law enforcement agencies.
| Law Enforcement Referrals | Warrants Issued | Arrests | Convictions |
|---|---|---|---|
3,687 |
2,720 |
2,577 |
2,122 |
