Michigan attorney sets bar for new low

A Southeast Michigan attorney will have to defend himself after being charged with larceny by false pretenses for more than $20,000. The counselor even bragged to his law partner by announcing he was married on an Australian vacation back in 2001. He claimed he married his girlfriend who he had been dating for several months.  He then placed her on his Blue Cross Blue Shield of Michigan health insurance as his wife. 

This continued until January 2009 when the senior partner decided to switch health insurance companies.  Someone tipped Blue Cross Blue Shield of Michigan that the couple never married and the alleged spouse had moved out of state.  Investigation revealed that while the couple had vacationed in Australia, there was no record of their marriage. Investigators requested a copy of the marriage license, which neither the counselor nor his girlfriend could produce. The scam caused a loss of more than $169,000 to Blue Cross Blue Shield of Michigan.

The attorney was charged with health care fraud - false claims and appeared for a preliminary exam in 2013. The counselor made a motion for dismissal because he wanted to confront the investigator who found that there was no record of the marriage.

The cost of obtaining the witness from Australia was too high to arrange. The judge dismissed the case based on the counselor’s motion.  Investigators turned to the Department of Justice and obtained certified records from the Australian government that there was no record of a marriage between the counselor and his girlfriend. Investigators also got tax records that showed neither of them had filed a tax return as married.

A public records check also indicated several unrelated arrests for the girlfriend.  Investigators obtained those reports, which showed that during booking, the girlfriend told officers she was single.  She made that same claim to her doctors. He was charged with a felony of larceny by false pretenses, which carries a penalty of 15 years in prison. The original charge of health care fraud carried a penalty of only four years. It appears that the counselor may have outsmarted himself.  Now his career may be down under.

We urge Blues members who suspect health care fraud to call our Anti-Fraud Hotline at 1-800-482-3787 or to report fraud at bcbsm.com.