BLUE CROSS BLUE SHIELD OF MASSACHUSETTS RECOVERS MORE THAN $670 MILLION THROUGH FRAUD PREVENTION EFFORTS, PASSING SAVINGS DIRECTLY TO MEMBERS

Blue Cross is protecting members' wallets ahead of International Fraud Awareness Week - and empowering them to fight back

BOSTON, Nov. 12, 2026 /PRNewswire/ -- Ahead of International Fraud Awareness Week, Blue Cross Blue Shield of Massachusetts (Blue Cross) announced a milestone in protecting members from rising healthcare costs. Over the last five years, Blue Cross' specialized fraud unit has worked hard to safeguard members and employer customers from fraudulent practices, recovering or saving more than $670M, with savings passed directly back to members.

Why it matters: Healthcare fraud drives up the cost of care for everyone. Nationally, an estimated $1 out of every $10 spent on healthcare is lost to fraudulent activity annually. By combining advanced analytical detection with rigorous investigation, Blue Cross holds individuals and entities committing fraud accountable. This targeted approach curbs unnecessary spending, directly protecting members and helping ensure affordable coverage.

Rising scams targeting members
Blue Cross' specialized fraud unit works year-round to monitor and stop fraud, waste, and abuse. Some of the most common scams Blue Cross is seeing today include:

• Unauthorized phone calls or texts: Unsolicited calls or texts asking to confirm certain information like their member ID number, password, date of birth, doctor's name or date of last service.
• Deceptive offers for "free" medical equipment: Receiving test kits, supplies or medical equipment that were not requested free of charge.
• Unordered tests and treatments: Charges for services or tests that were never ordered by an authorized healthcare provider.

The big picture: How members can prevent fraud
Members are an important first line of defense against fraud, waste and abuse. Blue Cross urges members to adopt the following protective measures:

• Protect your member ID: Treat your Blue Cross member card like a credit card. Never share it with unsolicited callers or unverified sources.
  
  
• Avoid suspicious links: Never click on links in unsolicited emails or text messages, especially those claiming to be from healthcare providers or insurers asking for immediate action or personal information.
  
  
• Review your Explanation of Benefits (EOB): Carefully check every EOB statement to ensure listed dates, providers and procedures accurately reflect services received.
  
  
• Beware of "free" offers: Be skeptical of unsolicited offers for "free" medical equipment, genetic testing kits or wellness exams that require insurance information.
  
  
• Never sign blank forms: Don't sign blank medical claim forms or agree to treatment descriptions that don't make sense.
  
  
• Safeguard personal medical history: Discuss treatment plans and prescriptions only with licensed, trusted healthcare professionals.

What they're saying:

Geoff Wood, senior director of fraud investigation and prevention, and senior associate general counsel at Blue Cross: "Healthcare fraud hits our members' hard-earned dollars directly – and we take that personally. That's why we work every day to stay ahead of bad actors by combining advanced analytics with dedicated oversight. When we detect and prevent fraudulent activity, we aren't just recovering funds - we're preserving the affordability and reliability of coverage for our members."

Reporting suspected fraud
Members who suspect improper billing, unauthorized card usage or fraudulent medical solicitations should report their concerns immediately. All reports are confidential and can be made anonymously:

• Blue Cross fraud hotline: 1-800-992-4100
• Email: [email protected]
• Mail: Attn: Fraud Investigation & Prevention
  Blue Cross Blue Shield of Massachusetts
  101 Huntington Ave. Suite 1300
  Boston, MA 02199-7611

Blue Cross encourages members to visit the Fraud Resource Page for more information.

About Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts (bluecrossma.org) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We are committed to showing up for everyone like they're the only one and guiding our members to the exceptional healthcare they deserve – affordably, equitably and seamlessly. In keeping with our commitment, we are rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Instagram, and LinkedIn.

SOURCE Blue Cross Blue Shield of Massachusetts