84 cases referred to law enforcement; 21 criminal convictions secured
INDIANAPOLIS, July 1 /PRNewswire/ --WellPoint, Inc. (NYSE: WLP) announced today that its Fraud and Abuse department, working with its affiliated health plans, recovered and saved almost $75 million in 2008 as a result of its anti-fraud efforts. These efforts led to 84 case referrals to law enforcement and/or licensing agencies.
This announcement comes the day after the Blue Cross and Blue Shield Association announced that its health care plans' anti-fraud investigations resulted in savings and recoveries of nearly $350 million in 2008, an increase of 43 percent from 2007. There were 1,087 cases referred to law enforcement agencies and licensing authorities, and 252 convictions and 140 civil actions, settlements and judgments. WellPoint, an independent licensee of the Blue Cross and Blue Shield Association, serves members through its Blue-licensed subsidiaries and their affiliates in 14 states.
Health care fraud is a serious problem that steals at least $68 billion every year, accounting for at least 3 percent of the total amount spent on health care annually, according to the National Health Care Anti-Fraud Association. Health care fraud is dangerous as well as expensive as it can involve unnecessary and excessive surgeries, procedures and prescriptions. WellPoint's affiliated health plans are committed to leading the fight in their local markets and working cooperatively with local law enforcement and other organizations.
"These anti-fraud results exemplify one way we can work toward the goal of decreasing health care costs through careful review of health care charges," said Lee Arian, WellPoint staff vice president for Fraud and Abuse. "These efforts have proven successful in uncovering and eliminating significant fraudulent and abusive activity in our health care community."
WellPoint estimates that for every $1 spent in preventing and investigating fraudulent activities the company recovers or saves $11 on behalf of its affiliated health plans' customers and members. Fraud and abuse investigations by WellPoint in 2008 led to 11 arrests and 21 criminal convictions.
About WellPoint, Inc.
WellPoint works to simplify the connection between Health, Care and Value. We help to improve the health of our communities, deliver better care to members, and provide greater value to our customers and shareholders. WellPoint is the nation's largest health benefits company, with approximately 35 million members in its affiliated health plans. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at www.wellpoint.com.
About the Blue Cross and Blue Shield Association
The Blue Cross and Blue Shield Association is a national federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 100 million members - one-in-three of all Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.
SOURCE WellPoint, Inc.