Insurance workers indicted, accused of fraud costing $500K-plus

BRANDON — Fourteen people, including three employees of Blue Cross & Blue Shield of Mississippi, have been indicted by a Rankin County grand jury on charges of insurance fraud, Attorney General Jim Hood said yesterday.

The investigation involved the State and School Employees Health Insurance Plan. Blue Cross/Blue Shield administers those health plans for the state.

An indictment alleges the three Blue Cross/Blue Shield employees processed claims for up to $44,000 to at least 11 state employees for reimbursement for medical procedures that never occurred.

Hood said the state employees cashed the checks and kicked back some of the money to the Blue Cross/Blue Shield employees, with the total loss to the state equaling more than $500,000. Hood said Blue Cross/Blue Shield had made full restitution to the state.

The investigation began when a participant returned her check to Blue Cross/Blue Shield, which contacted authorities. Hood said the company cooperated with the investigation.

Hood’s office will prosecute the cases. No court dates have been set. If convicted, Hood said each defendant faces a maximum penalty of five year in prison.

All the defendants are charged with conspiracy, insurance fraud, mail fraud and false representation.

Source: Associated Press