Who Is Really Committing Medicare Fraud?
Four of the 44 Medicare carriers (the private companies that administer the Medicare program under contract with the Health Care Financing Administration) have pleaded guilty to criminal fraud charges. Executives at a fifth carrier were convicted of fraud: Blue Cross and Blue Shield of Illinois paid $4 million in criminal fines and $140 million to settle civil charges. Four managers have pleaded guilty to criminal charges and four others are in trial in federal court. Pennsylvania Blue Shield paid $38.5 million in a civil settlement. Five officials pleaded guilty to criminal charges. Blue Cross and Blue Shield of Colorado pleaded guilty to obstructing a federal audit and paid a fine; also paid $6.1 million to settle civil claims. New Mexico Blue Cross and Blue Shield pleaded guilty to obstructing a federal audit and paid a fine; is paying $5.1 million to settle civil claims. Blue Shield of Western New York a federal jury convicted two former executives of defrauding the Medic
