Former Blue Shield of California employee under investigation for fraud

 Former Blue Shield of California employee under investigation for fraud

Photo: Blanchi Costela/Getty Images

Blue Shield of California has confirmed that it reported a former employee to law enforcement after learning of alleged fraud on the part of the former administrative staffer or executive.

The employee allegedly misrepresented her qualifications.

“We can confirm that we recently learned a former employee misrepresented her name and licensure, and we reported that to law enforcement,” Blue Shield of California said by statement. “This individual no longer works for our organization. It’s important to note that, while employed at Blue Shield of California, this person’s role was primarily administrative. Because this is an active fraud investigation, as well as a personnel matter, we cannot discuss more details at this time. We are confident the authorities will conduct a thorough investigation and we are committed to supporting that effort.”

Blue Shield of California did not name the employee, nor did the company confirm to Healthcare Finance News that she was no longer at the company because her employment was terminated.

However, Blue Shield of California confirmed in a statement to the San Diego Union-Tribune that it “involuntarily terminated” one of its executives, an interim medical director, after learning that she allegedly misrepresented her qualifications. 

– This story will be updated as more information becomes available.

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Fallon Wolken

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