The National Heath Care Anti-Fraud Association estimates conservatively that health care fraud costs the nation about $68 billion annually — about 3 percent of the nation's $2.26 trillion in health care spending. Other estimates range as high as 10 percent of annual health care expenditure, or $230 billion.

Health care fraud is a felony under Michigan's Health Care False Claims Act, punishable by up to four years in prison, a $50,000 fine and loss of health insurance. It's also a federal criminal offense under the Health Insurance Portability and Accountability Act. 

Blue Cross Blue Shield of Michigan's fraud investigation unit coordinates investigations with the FBI, the Office of Inspector General for the U.S. Department of Health and Human Services, Michigan State Police and local police departments. It also assists with state and federal prosecutions.

Current Statistics

The following data represents Blue Cross Blue Shield of Michigan's fraud investigation unit activity from July 1980 to March 2016.

Cases opened: 49,386

Cases closed: 48,117

Referred for recovery/cost savings: $387,543,274.82

Many cases handled have resulted in referrals to law enforcement agencies.

          Law enforcement referrals: 4,325

          Warrants issued: 3,458

          Arrests: 3,401

          Convictions: 2,820

Suspect fraud?

Call us now, toll-free.

TTY user?
To reach any number listed here, start by calling 711.

Anti-Fraud Hotline:

Medicare Anti-Fraud Hotline:

Blue Cross Complete of Michigan Anti-Fraud Hotline:

©1996-2016 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan.

State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted.

Site Map  |  Feedback  |  Important Legal and Privacy Information

Explanation of Level A Conformance
Better Business Bureau Online Seal of Reliability