Man steals Blues employee's insurance information to obtain fentanyl
A Blue Care Network employee called Blue Cross Blue Shield of Michigan's Corporate and Financial Investigations department after she was contacted by an official at the Kentwood Police Department.
The police officer told her that an unknown person had been filling prescriptions for fentanyl (a powerful pain medication) in her husband's name and using her Blue Care Network coverage to pay for the prescriptions.
An investigation revealed that the suspect in this case had once worked with the employee's husband and had copied down his insurance information from employee files. The suspect was also filling forged fentanyl prescriptions, in both his own name and his wife's name.
The suspect was arrested by the Kentwood Police Department when he picked up one of his forged prescriptions. He was subsequently charged with Obtaining a Controlled Substance by Fraud and Identity Theft under the Health Care False Claims Act.
He pled guilty and was sentenced to 60 months probation with incarceration for the first eight months. He also has to pay $117,969.52 in restitution to Blue Care Network and pay $3,357.38 for investigative costs.
Members who suspect health care fraud are urged to call our Anti-Fraud Hotline at 1-800-482-3787, or report fraud through our website.