|August 31, 2006|
Inspector General Recognizes Two BlueCross Fraud Unit Employees with Integrity Award
CHATTANOOGA, Tenn. — The U.S. Department of Health and Human Services (HHS) recently recognized two BlueCross BlueShield of Tennessee Special Investigation Unit employees for their assistance to the government in the criminal prosecution of a Tennessee oncologist.
Senior Fraud Investigator Rick McBride and Investigative Analyst Scott Ogrodowczyk each received the Inspector General’s Integrity Award for their efforts in investigating Dr. Young Moon, who was convicted and sentenced to 15 years in prison for providing inadequate doses of chemotherapy drugs to cancer patients, while billing for full doses.
“Rick and Scott demonstrated a unique approach and a strong dedication to investigating this case,” said Jack Price, senior manager for BlueCross’ special investigation unit. “Their efforts paid off in not only protecting our corporate assets, but also the interests of our members.”
Health care fraud is a crime that costs the health care industry as much as $90 billion annually. Beyond the financial losses, fraud and abuse jeopardize the safety and quality of patient care.
The Department of Health and Human Services annually recognizes individuals, who protect the integrity of HHS programs. Since 2004, BlueCross has been honored by the Inspector General’s Office with three Integrity Awards.
In response to the rising cost of health care fraud, in 1983, BlueCross BlueShield of Tennessee established an investigative unit dedicated to detecting, preventing and prosecuting health care fraud. These units are located in both Chattanooga and Memphis to provide statewide coverage. The BlueCross Special Investigations Unit (SIU) consists of individuals whose backgrounds include law enforcement, investigative, legal, auditing, claims analysis, and medical professions.
Suspected cases of fraud and abuse can be reported via a toll-free hotline at 1-800-496-9600 or visit www.bcbst.com and click on the fraud link.
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